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 $95.50 Median $1,202.26 Typical High $7,762.47 | Facility | None | $95.50 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $162.18 | Professional | None | $85.11 | $112.20 | $162.18 |
BCBS Illinois Setting Facility Modifier None Typical Low $128.82 Median $154.88 Typical High $977.24 | Facility | None | $128.82 | $154.88 | $977.24 |
BCBS Illinois Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $223.87 | Professional | None | $107.15 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $512.86 | Facility | None | $114.82 | $162.18 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $141.25 Typical High $199.53 | Professional | None | $60.26 | $141.25 | $199.53 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $323.59 | Professional | None | $100.00 | $165.96 | $323.59 |
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 $104.71 Median $109.65 Typical High $158.49 | Professional | None | $104.71 | $109.65 | $158.49 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $218.78 | Professional | None | $89.13 | $131.83 | $218.78 |
7 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 $43.65 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $66.07 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $77.62 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $61.66 | $77.62 | $89.13 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 58 · Staged procedure | $104.71 | $104.71 | $123.03 |
Where Illinois sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 22nd of 51
$145
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.