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 $144.54 Median $331.13 Typical High $4,677.35 | Facility | None | $144.54 | $331.13 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $251.19 | Professional | None | $112.20 | $154.88 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $234.42 | Professional | None | $120.23 | $186.21 | $234.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $1,659.59 | Facility | None | $114.82 | $186.21 | $1,659.59 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $302.00 | Professional | None | $154.88 | $208.93 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $660.69 | Facility | None | $100.00 | $147.91 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $275.42 | Professional | None | $147.91 | $190.55 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $478.63 | Professional | None | $151.36 | $229.09 | $478.63 |
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 $134.90 Median $162.18 Typical High $223.87 | Professional | None | $134.90 | $162.18 | $223.87 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $229.09 | Professional | None | $26.92 | $33.11 | $229.09 |
United Setting Facility Modifier None Typical Low $141.25 Median $537.03 Typical High $1,949.84 | Facility | None | $141.25 | $537.03 | $1,949.84 |
United Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $288.40 | Professional | None | $131.83 | $177.83 | $288.40 |
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 $54.95 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $93.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $77.62 | $93.33 | $114.82 |
Where Illinois sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$191
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.