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 $177.83 Median $1,318.26 Typical High $5,623.41 | Facility | None | $177.83 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $281.84 | Professional | None | $112.20 | $165.96 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | None | $162.18 | $177.83 | $177.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $2,187.76 | Facility | None | $257.04 | $309.03 | $2,187.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $323.59 | Professional | None | $125.89 | $204.17 | $323.59 |
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 $117.49 Median $186.21 Typical High $316.23 | Professional | None | $117.49 | $186.21 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $407.38 | Professional | None | $144.54 | $245.47 | $407.38 |
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 $147.91 Median $151.36 Typical High $257.04 | Professional | None | $147.91 | $151.36 | $257.04 |
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 $123.03 Median $199.53 Typical High $338.84 | Professional | None | $123.03 | $199.53 | $338.84 |
6 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 $51.29 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $77.62 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $123.03 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 26th of 51
$195
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.