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 $162.18 Median $537.03 Typical High $5,128.61 | Facility | None | $162.18 | $537.03 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $257.04 | Professional | None | $117.49 | $162.18 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $3,090.30 | Facility | None | $190.55 | $309.03 | $3,090.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $346.74 | Professional | None | $154.88 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $257.04 Typical High $812.83 | Facility | None | $177.83 | $257.04 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $288.40 | Professional | None | $120.23 | $173.78 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $398.11 | Professional | None | $147.91 | $245.47 | $398.11 |
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 $158.49 Median $165.96 Typical High $257.04 | Professional | None | $158.49 | $165.96 | $257.04 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $323.59 | Professional | None | $123.03 | $177.83 | $323.59 |
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 $60.26 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $60.26 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $24.55 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $91.20 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $85.11 | $112.20 | $131.83 |
Where Illinois sits
The same service costs 3.9 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· 24th of 51
$204
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.