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 $446.68 Median $1,148.15 Typical High $7,762.47 | Facility | None | $446.68 | $1,148.15 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $676.08 | Professional | None | $323.59 | $389.05 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $6,025.60 | Facility | None | $2,630.27 | $3,890.45 | $6,025.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $812.83 | Professional | None | $467.74 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,023.29 | $3,162.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $776.25 | Professional | None | $407.38 | $501.19 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,318.26 | Professional | None | $416.87 | $645.65 | $1,318.26 |
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 $416.87 Median $489.78 Typical High $616.60 | Professional | None | $416.87 | $489.78 | $616.60 |
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 $363.08 Median $512.86 Typical High $891.25 | Professional | None | $363.08 | $512.86 | $891.25 |
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 $162.18 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $66.07 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $245.47 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $66.07 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $229.09 | $275.42 | $309.03 |
Where Illinois sits
The same service costs 3.8 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· 20th of 51
$575
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.