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 $398.11 Median $741.31 Typical High $5,495.41 | Facility | None | $398.11 | $741.31 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $794.33 | Professional | None | $323.59 | $489.78 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $398.11 | Professional | None | $144.54 | $144.54 | $398.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $5,495.41 | Facility | None | $338.84 | $549.54 | $5,495.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $912.01 | Professional | None | $331.13 | $575.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $776.25 | Facility | None | $316.23 | $446.68 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $891.25 | Professional | None | $316.23 | $537.03 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $1,905.46 | Professional | None | $323.59 | $588.84 | $1,905.46 |
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 $302.00 Median $346.74 Typical High $575.44 | Professional | None | $302.00 | $346.74 | $575.44 |
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 $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $1,047.13 | Professional | None | $323.59 | $645.65 | $1,047.13 |
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 $147.91 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $147.91 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $60.26 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $223.87 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $29.51 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $371.54 |
Where Illinois sits
The same service costs 4.1 times more in Wisconsin than in Texas. 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· 31st of 51
$575
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.