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 $371.54 Median $933.25 Typical High $5,370.32 | Facility | None | $371.54 | $933.25 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $588.84 | Professional | None | $309.03 | $371.54 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $323.59 | Professional | None | $239.88 | $316.23 | $323.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $3,890.45 | Facility | None | $457.09 | $691.83 | $3,890.45 |
BCBS Illinois Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $562.34 | Professional | None | $323.59 | $467.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $812.83 | Facility | None | $426.58 | $588.84 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $537.03 | Professional | None | $257.04 | $371.54 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $912.01 | Professional | None | $275.42 | $446.68 | $912.01 |
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 $371.54 Median $371.54 Typical High $436.52 | Professional | None | $371.54 | $371.54 | $436.52 |
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 $446.68 Median $1,071.52 Typical High $3,019.95 | Facility | None | $446.68 | $1,071.52 | $3,019.95 |
United Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $724.44 | Professional | None | $288.40 | $371.54 | $724.44 |
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 $154.88 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $229.09 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $257.04 |
Where Illinois sits
The same service costs 5.8 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· 23rd of 51
$417
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.