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 $186.21 Median $602.56 Typical High $4,677.35 | Facility | None | $186.21 | $602.56 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $302.00 Typical High $380.19 | Professional | None | $123.03 | $302.00 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | None | $181.97 | $181.97 | $194.98 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,096.48 | $1,659.59 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $588.84 | Professional | None | $169.82 | $363.08 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,348.96 Typical High $1,659.59 | Facility | None | $478.63 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $549.54 | Professional | None | $194.98 | $281.84 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $1,047.13 | Professional | None | $194.98 | $436.52 | $1,047.13 |
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 $173.78 Median $181.97 Typical High $457.09 | Professional | None | $173.78 | $181.97 | $457.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $478.63 | Professional | None | $33.11 | $33.11 | $478.63 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $616.60 | Professional | None | $147.91 | $323.59 | $616.60 |
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 $69.18 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $69.18 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $27.54 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $104.71 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $20.89 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.80 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $97.72 | $208.93 | $245.47 |
Where Illinois sits
The same service costs 4.0 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· 33rd of 51
$316
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.