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 $223.87 Median $1,318.26 Typical High $5,623.41 | Facility | None | $223.87 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $251.19 | Professional | None | $147.91 | $204.17 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $1,819.70 | Facility | None | $218.78 | $354.81 | $1,819.70 |
BCBS Illinois Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $407.38 | Professional | None | $169.82 | $257.04 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $512.86 | Facility | None | $208.93 | $295.12 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $407.38 | Professional | None | $158.49 | $245.47 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $512.86 | Professional | None | $190.55 | $323.59 | $512.86 |
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 $199.53 Median $208.93 Typical High $323.59 | Professional | None | $199.53 | $208.93 | $323.59 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
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 $70.79 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $154.88 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$251
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.