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 $363.08 Median $1,288.25 Typical High $5,623.41 | Facility | None | $363.08 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $630.96 | Professional | None | $331.13 | $389.05 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $4,677.35 | Facility | None | $204.17 | $309.03 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $851.14 | Professional | None | $436.52 | $602.56 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $275.42 Typical High $512.86 | Facility | None | $190.55 | $275.42 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $691.83 | Professional | None | $371.54 | $446.68 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,230.27 | Professional | None | $398.11 | $588.84 | $1,230.27 |
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 $549.54 | Professional | None | $436.52 | $457.09 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $501.19 | Professional | None | $33.11 | $48.98 | $501.19 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $707.95 | Professional | None | $331.13 | $398.11 | $707.95 |
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 $165.96 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $275.42 |
Where Illinois sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 30th of 51
$437
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.