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 $331.13 Median $933.25 Typical High $5,370.32 | Facility | None | $331.13 | $933.25 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $524.81 | Professional | None | $251.19 | $338.84 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | None | $295.12 | $436.52 | $436.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $3,388.44 | Facility | None | $426.58 | $691.83 | $3,388.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $776.25 | Professional | None | $309.03 | $467.74 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $524.81 Typical High $741.31 | Facility | None | $275.42 | $524.81 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $602.56 | Professional | None | $275.42 | $363.08 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $1,202.26 | Professional | None | $338.84 | $512.86 | $1,202.26 |
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 $316.23 Median $331.13 Typical High $501.19 | Professional | None | $316.23 | $331.13 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $478.63 | Professional | None | $33.11 | $43.65 | $478.63 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $616.60 | Professional | None | $257.04 | $338.84 | $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 $125.89 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $125.89 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $50.12 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $218.78 | $257.04 |
Where Illinois sits
The same service costs 4.5 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· 33rd of 51
$372
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.