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 $891.25 Median $3,388.44 Typical High $9,772.37 | Facility | None | $891.25 | $3,388.44 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | None | $794.33 | $891.25 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,884.03 | $8,912.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,288.25 | Professional | None | $831.76 | $1,202.26 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $4,168.69 | Facility | None | $1,288.25 | $2,344.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Professional | None | $630.96 | $912.01 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,905.46 | Professional | None | $630.96 | $977.24 | $1,905.46 |
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 $831.76 Median $851.14 Typical High $912.01 | Professional | None | $831.76 | $851.14 | $912.01 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $5,623.41 | Facility | None | $1,047.13 | $2,454.71 | $5,623.41 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,584.89 | Professional | None | $660.69 | $851.14 | $1,584.89 |
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 $389.05 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $630.96 | $630.96 |
Where Illinois sits
The same service costs 4.6 times more in Alaska than in New York. 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· 32nd of 51
$1,023
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.