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 $229.09 Median $1,318.26 Typical High $5,623.41 | Facility | None | $229.09 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $251.19 | Professional | None | $131.83 | $199.53 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $4,786.30 | Facility | None | $257.04 | $416.87 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $302.00 | Professional | None | $138.04 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $537.03 | Facility | None | $239.88 | $346.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $338.84 | Professional | None | $128.82 | $181.97 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $588.84 | Professional | None | $158.49 | $281.84 | $588.84 |
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 $154.88 Median $158.49 Typical High $302.00 | Professional | None | $154.88 | $158.49 | $302.00 |
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 $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $389.05 | Professional | None | $138.04 | $213.80 | $389.05 |
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 $66.07 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $66.07 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $26.30 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $19.95 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.18 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $93.33 | $147.91 | $162.18 |
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· 35th of 51
$204
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.