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 $190.55 Median $1,148.15 Typical High $5,623.41 | Facility | None | $190.55 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $251.19 | Professional | None | $151.36 | $223.87 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $2,818.38 | Facility | None | $281.84 | $457.09 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $512.86 | Professional | None | $173.78 | $288.40 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $380.19 Typical High $537.03 | Facility | None | $263.03 | $380.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $398.11 | Professional | None | $117.49 | $194.98 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $512.86 | Professional | None | $186.21 | $331.13 | $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 $181.97 Median $194.98 Typical High $338.84 | Professional | None | $181.97 | $194.98 | $338.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
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 $154.88 Median $251.19 Typical High $436.52 | Professional | None | $154.88 | $251.19 | $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 $75.86 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $75.86 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $30.20 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $104.71 | $151.36 | $177.83 |
Where Illinois sits
The same service costs 4.4 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· 37th of 51
$240
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.