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 $251.19 Median $1,318.26 Typical High $5,623.41 | Facility | None | $251.19 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $251.19 | Professional | None | $154.88 | $229.09 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $2,884.03 | Facility | None | $281.84 | $457.09 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $501.19 | Professional | None | $177.83 | $295.12 | $501.19 |
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 $169.82 Median $223.87 Typical High $416.87 | Professional | None | $169.82 | $223.87 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $562.34 | Professional | None | $204.17 | $338.84 | $562.34 |
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 $190.55 Median $194.98 Typical High $338.84 | Professional | None | $190.55 | $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 $158.49 Median $245.47 Typical High $436.52 | Professional | None | $158.49 | $245.47 | $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 $77.62 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $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 $15.49 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $177.83 |
Where Illinois sits
The same service costs 3.5 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
$251
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.