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 $263.03 Median $575.44 Typical High $5,370.32 | Facility | None | $263.03 | $575.44 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $323.59 | Professional | None | $181.97 | $288.40 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | None | $186.21 | $186.21 | $239.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $2,041.74 | Facility | None | $446.68 | $724.44 | $2,041.74 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $478.63 | Professional | None | $223.87 | $363.08 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $870.96 | Facility | None | $416.87 | $588.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $288.40 Typical High $537.03 | Professional | None | $100.00 | $288.40 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $380.19 Typical High $575.44 | Professional | None | $199.53 | $380.19 | $575.44 |
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 $218.78 Median $223.87 Typical High $416.87 | Professional | None | $218.78 | $223.87 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | None | $33.11 | $33.11 | $46.77 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,235.94 | Facility | None | $446.68 | $1,047.13 | $3,235.94 |
United Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $524.81 | Professional | None | $131.83 | $223.87 | $524.81 |
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 $93.33 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $141.25 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $28.18 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $131.83 | $177.83 | $218.78 |
Where Illinois sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 27th of 51
$288
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.