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 $125.89 Median $1,318.26 Typical High $5,623.41 | Facility | None | $125.89 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $199.53 | Professional | None | $77.62 | $120.23 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $147.91 Typical High $234.42 | Professional | None | $89.13 | $147.91 | $234.42 |
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 $100.00 Median $181.97 Typical High $288.40 | Professional | None | $100.00 | $181.97 | $288.40 |
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 $186.21 | Professional | None | $104.71 | $109.65 | $186.21 |
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 $85.11 Median $144.54 Typical High $245.47 | Professional | None | $85.11 | $144.54 | $245.47 |
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 $37.15 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $14.79 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $54.95 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $10.96 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $79.43 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $51.29 | $79.43 | $89.13 |
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· 27th of 51
$141
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.