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 $295.12 Median $1,202.26 Typical High $7,762.47 | Facility | None | $295.12 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $467.74 | Professional | None | $263.03 | $295.12 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $3,801.89 | Facility | None | $204.17 | $309.03 | $3,801.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $588.84 | Professional | None | $363.08 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $363.08 | Facility | None | $141.25 | $251.19 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $549.54 | Professional | None | $251.19 | $323.59 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $1,000.00 | Professional | None | $309.03 | $478.63 | $1,000.00 |
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 $354.81 Median $363.08 Typical High $436.52 | Professional | None | $354.81 | $363.08 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $398.11 | Professional | None | $33.11 | $39.81 | $398.11 |
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 $257.04 Median $316.23 Typical High $562.34 | Professional | None | $257.04 | $316.23 | $562.34 |
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 $131.83 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $218.78 |
Where Illinois sits
The same service costs 5.5 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· 26th 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.