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 $302.00 Median $1,148.15 Typical High $5,888.44 | Facility | None | $302.00 | $1,148.15 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $426.58 | Professional | None | $281.84 | $302.00 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | None | $245.47 | $346.74 | $346.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,467.37 Median $5,623.41 Typical High $8,511.38 | Facility | None | $3,467.37 | $5,623.41 | $8,511.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $457.09 | Professional | None | $309.03 | $371.54 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,248.07 Typical High $6,760.83 | Facility | None | $758.58 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $478.63 | Professional | None | $316.23 | $354.81 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $1,288.25 | Professional | None | $309.03 | $436.52 | $1,288.25 |
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 $346.74 Median $371.54 Typical High $407.38 | Professional | None | $346.74 | $371.54 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | None | $33.11 | $33.11 | $36.31 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,570.40 | $7,585.78 |
United Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $549.54 | Professional | None | $295.12 | $338.84 | $549.54 |
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 $141.25 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $208.93 |
Where Illinois sits
The same service costs 5.5 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
$355
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.