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 $169.82 Median $398.11 Typical High $4,786.30 | Facility | None | $169.82 | $398.11 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $263.03 | Professional | None | $114.82 | $186.21 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | None | $151.36 | $213.80 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $1,659.59 | Facility | None | $257.04 | $407.38 | $1,659.59 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $380.19 | Professional | None | $154.88 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $537.03 | Facility | None | $239.88 | $338.84 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $363.08 | Professional | None | $177.83 | $239.88 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $616.60 | Professional | None | $177.83 | $331.13 | $616.60 |
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 $158.49 Median $165.96 Typical High $316.23 | Professional | None | $158.49 | $165.96 | $316.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $309.03 | Professional | None | $33.11 | $33.11 | $309.03 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,071.52 Typical High $3,235.94 | Facility | None | $446.68 | $1,071.52 | $3,235.94 |
United Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $426.58 | Professional | None | $134.90 | $234.42 | $426.58 |
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 $64.57 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $64.57 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $95.50 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.88 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $89.13 | $141.25 | $162.18 |
Where Illinois sits
The same service costs 3.6 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· 28th of 51
$234
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.