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 $141.25 Median $263.03 Typical High $4,677.35 | Facility | None | $141.25 | $263.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $316.23 | Professional | None | $123.03 | $199.53 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS Illinois Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $2,754.23 | Facility | None | $169.82 | $208.93 | $2,754.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $389.05 | Professional | None | $141.25 | $229.09 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $331.13 | Professional | None | $69.18 | $173.78 | $331.13 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $512.86 | Professional | None | $141.25 | $269.15 | $512.86 |
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 $144.54 Median $147.91 Typical High $275.42 | Professional | None | $144.54 | $147.91 | $275.42 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $457.09 Typical High $1,819.70 | Facility | None | $141.25 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $371.54 | Professional | None | $120.23 | $213.80 | $371.54 |
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 $58.88 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $58.88 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $23.99 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $89.13 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.02 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $83.18 | $128.82 | $162.18 |
Where Illinois sits
The same service costs 4.5 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· 21st of 51
$219
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.