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 $309.03 Median $1,698.24 Typical High $5,623.41 | Facility | None | $309.03 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $338.84 | Professional | None | $234.42 | $295.12 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,884.03 | Facility | None | $1,000.00 | $1,479.11 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $426.58 | Professional | None | $239.88 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,584.89 | Facility | None | $630.96 | $1,202.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $489.78 | Professional | None | $269.15 | $323.59 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $954.99 | Professional | None | $263.03 | $407.38 | $954.99 |
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 $269.15 Median $288.40 Typical High $416.87 | Professional | None | $269.15 | $288.40 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
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 $239.88 Median $316.23 Typical High $537.03 | Professional | None | $239.88 | $316.23 | $537.03 |
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 $117.49 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $46.77 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $218.78 |
Where Illinois sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 32nd of 51
$316
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.