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 $1,122.02 Typical High $5,888.44 | Facility | None | $295.12 | $1,122.02 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $501.19 | Professional | None | $263.03 | $309.03 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $371.54 | Professional | None | $302.00 | $302.00 | $371.54 |
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 $208.93 Median $295.12 Typical High $537.03 | Professional | None | $208.93 | $295.12 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $912.01 | Professional | None | $295.12 | $467.74 | $912.01 |
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 $363.08 Median $371.54 Typical High $436.52 | Professional | None | $363.08 | $371.54 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $416.87 | Professional | None | $33.11 | $38.02 | $416.87 |
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 $251.19 Median $309.03 Typical High $562.34 | Professional | None | $251.19 | $309.03 | $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 $134.90 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $213.80 |
Where Illinois sits
The same service costs 5.6 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· 24th 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.