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 $501.19 Median $891.25 Typical High $5,495.41 | Facility | None | $501.19 | $891.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $954.99 | Professional | None | $398.11 | $602.56 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | None | $467.74 | $467.74 | $478.63 |
BCBS Illinois Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $5,888.44 | Facility | None | $380.19 | $616.60 | $5,888.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $1,096.48 | Professional | None | $407.38 | $707.95 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $512.86 Typical High $812.83 | Facility | None | $363.08 | $512.86 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,071.52 | Professional | None | $389.05 | $645.65 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $1,778.28 | Professional | None | $398.11 | $691.83 | $1,778.28 |
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 $371.54 Median $426.58 Typical High $676.08 | Professional | None | $371.54 | $426.58 | $676.08 |
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 $398.11 Median $776.25 Typical High $1,230.27 | Professional | None | $398.11 | $776.25 | $1,230.27 |
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 $181.97 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $181.97 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $72.44 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $275.42 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $36.31 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $426.58 |
Where Illinois sits
The same service costs 4.3 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· 30th of 51
$708
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.