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 $204.17 Median $812.83 Typical High $5,128.61 | Facility | None | $204.17 | $812.83 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $338.84 | Professional | None | $162.18 | $208.93 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $331.13 | Professional | None | $128.82 | $177.83 | $331.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $2,630.27 | Facility | None | $204.17 | $309.03 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $407.38 | Professional | None | $251.19 | $338.84 | $407.38 |
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 $223.87 Median $288.40 Typical High $380.19 | Professional | None | $223.87 | $288.40 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $724.44 | Professional | None | $229.09 | $338.84 | $724.44 |
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 $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $288.40 | Professional | None | $33.11 | $33.11 | $288.40 |
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 $181.97 Median $229.09 Typical High $407.38 | Professional | None | $181.97 | $229.09 | $407.38 |
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 $93.33 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $28.18 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $151.36 |
Where Illinois sits
The same service costs 5.1 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· 21st of 51
$275
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.