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 $165.96 Median $562.34 Typical High $5,128.61 | Facility | None | $165.96 | $562.34 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $309.03 | Professional | None | $112.20 | $194.98 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | None | $114.82 | $181.97 | $181.97 |
BCBS Illinois Setting Facility Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,344.23 | Facility | None | $977.24 | $1,318.26 | $2,344.23 |
BCBS Illinois Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $281.84 | Professional | None | $120.23 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,202.26 Typical High $1,513.56 | Facility | None | $478.63 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $338.84 | Professional | None | $125.89 | $204.17 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $602.56 | Professional | None | $134.90 | $269.15 | $602.56 |
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 $281.84 | Professional | None | $131.83 | $134.90 | $281.84 |
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 $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $363.08 | Professional | None | $112.20 | $199.53 | $363.08 |
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 $56.23 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $22.39 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $83.18 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $128.82 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $77.62 | $128.82 | $151.36 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 28th of 51
$200
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.