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 $331.13 Median $1,348.96 Typical High $5,623.41 | Facility | None | $331.13 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $489.78 | Professional | None | $281.84 | $309.03 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $3,981.07 | Facility | None | $204.17 | $309.03 | $3,981.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $724.44 | Professional | None | $380.19 | $512.86 | $724.44 |
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 $295.12 Median $380.19 Typical High $588.84 | Professional | None | $295.12 | $380.19 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $1,071.52 | Professional | None | $331.13 | $501.19 | $1,071.52 |
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 $371.54 Median $389.05 Typical High $467.74 | Professional | None | $371.54 | $389.05 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $426.58 | Professional | None | $33.11 | $41.69 | $426.58 |
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 $275.42 Median $338.84 Typical High $602.56 | Professional | None | $275.42 | $338.84 | $602.56 |
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 $141.25 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $234.42 |
Where Illinois sits
The same service costs 5.8 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· 29th of 51
$380
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.