How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $134.90 Median $1,318.26 Typical High $5,623.41 | Facility | None | $134.90 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $213.80 | Professional | None | $79.43 | $125.89 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $1,548.82 | Facility | None | $257.04 | $309.03 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $245.47 | Professional | None | $89.13 | $154.88 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $234.42 | Professional | None | $83.18 | $134.90 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $309.03 | Professional | None | $102.33 | $190.55 | $309.03 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $194.98 | Professional | None | $104.71 | $109.65 | $194.98 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $251.19 | Professional | None | $87.10 | $147.91 | $251.19 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $37.15 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $14.79 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $54.95 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $10.96 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $81.28 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $51.29 | $81.28 | $93.33 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 79 · Unrelated procedure after surgery | $251.19 | $251.19 | $251.19 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Illinois· 23rd of 51
$148
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.