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 $144.54 Median $1,348.96 Typical High $5,623.41 | Facility | None | $144.54 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | None | $114.82 | $125.89 | $154.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $1,584.89 | Facility | None | $234.42 | $354.81 | $1,584.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $251.19 | Professional | None | $144.54 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $512.86 | Facility | None | $218.78 | $309.03 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $257.04 | Professional | None | $147.91 | $199.53 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $457.09 | Professional | None | $154.88 | $218.78 | $457.09 |
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 $154.88 Median $158.49 Typical High $204.17 | Professional | None | $154.88 | $158.49 | $204.17 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $204.17 | Professional | None | $23.99 | $33.11 | $204.17 |
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 $128.82 Median $162.18 Typical High $275.42 | Professional | None | $128.82 | $162.18 | $275.42 |
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 $61.66 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $91.20 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $91.20 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $85.11 | $91.20 | $102.33 |
Where Illinois sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 27th of 51
$182
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.