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 $794.33 Typical High $5,128.61 | Facility | None | $204.17 | $794.33 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $213.80 | Professional | None | $109.65 | $144.54 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $1,862.09 | Facility | None | $177.83 | $288.40 | $1,862.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $281.84 | Professional | None | $173.78 | $234.42 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $275.42 | Professional | None | $154.88 | $186.21 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $467.74 | Professional | None | $165.96 | $239.88 | $467.74 |
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 $177.83 Median $181.97 Typical High $223.87 | Professional | None | $177.83 | $181.97 | $223.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $194.98 | Professional | None | $33.11 | $33.11 | $194.98 |
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 $134.90 Median $165.96 Typical High $295.12 | Professional | None | $134.90 | $165.96 | $295.12 |
7 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 $69.18 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $104.71 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $114.82 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $144.54 | $144.54 | $144.54 |
Where Illinois sits
The same service costs 4.9 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· 30th of 51
$186
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.