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 $239.88 Median $1,318.26 Typical High $5,623.41 | Facility | None | $239.88 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $323.59 | Professional | None | $199.53 | $213.80 | $323.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $2,570.40 | Facility | None | $204.17 | $309.03 | $2,570.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $524.81 | Professional | None | $251.19 | $338.84 | $524.81 |
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 $218.78 Median $257.04 Typical High $398.11 | Professional | None | $218.78 | $257.04 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $537.03 | Professional | None | $229.09 | $338.84 | $537.03 |
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 $245.47 Median $257.04 Typical High $338.84 | Professional | None | $245.47 | $257.04 | $338.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
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 $158.49 Median $204.17 Typical High $407.38 | Professional | None | $158.49 | $204.17 | $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 $91.20 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $91.20 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $165.96 |
Where Illinois sits
The same service costs 5.0 times more in Alaska than in Florida. 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
$251
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.