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 $208.93 Median $1,318.26 Typical High $5,623.41 | Facility | None | $208.93 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $223.87 | Professional | None | $102.33 | $162.18 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $1,445.44 | Facility | None | $194.98 | $295.12 | $1,445.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $346.74 | Professional | None | $125.89 | $204.17 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $346.74 | Facility | None | $134.90 | $245.47 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $302.00 | Professional | None | $87.10 | $169.82 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $549.54 | Professional | None | $128.82 | $239.88 | $549.54 |
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 $131.83 Median $134.90 Typical High $245.47 | Professional | None | $131.83 | $134.90 | $245.47 |
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 $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $346.74 | Professional | None | $112.20 | $194.98 | $346.74 |
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 $53.70 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $53.70 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $81.28 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $75.86 | $112.20 | $144.54 |
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· 26th of 51
$195
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.