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 $446.68 Median $1,698.24 Typical High $5,623.41 | Facility | None | $446.68 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $537.03 | Professional | None | $354.81 | $416.87 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,238.72 | $3,311.31 | $5,754.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $933.25 | Professional | None | $407.38 | $616.60 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,630.27 Typical High $3,311.31 | Facility | None | $630.96 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $758.58 | Professional | None | $269.15 | $389.05 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $1,047.13 | Professional | None | $354.81 | $630.96 | $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 $436.52 Median $457.09 Typical High $616.60 | Professional | None | $436.52 | $457.09 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $537.03 | Professional | None | $33.11 | $53.70 | $537.03 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $870.96 | Professional | None | $380.19 | $512.86 | $870.96 |
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 $177.83 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $316.23 |
Where Illinois sits
The same service costs 6.0 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
$490
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.