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 $257.04 Median $1,513.56 Typical High $7,079.46 | Facility | None | $257.04 | $1,513.56 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $295.12 | Professional | None | $190.55 | $204.17 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $4,786.30 | Facility | None | $2,041.74 | $2,884.03 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $338.84 | Professional | None | $218.78 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,691.53 Typical High $3,311.31 | Facility | None | $891.25 | $2,691.53 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $331.13 | Professional | None | $213.80 | $263.03 | $331.13 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $794.33 | Professional | None | $208.93 | $295.12 | $794.33 |
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 $239.88 Median $251.19 Typical High $275.42 | Professional | None | $239.88 | $251.19 | $275.42 |
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 $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $363.08 | Professional | None | $190.55 | $218.78 | $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 $95.50 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $134.90 | $141.25 | $141.25 |
Where Illinois sits
The same service costs 5.9 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· 29th of 51
$245
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.