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 $1,318.26 Typical High $5,623.41 | Facility | None | $162.18 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $251.19 | Professional | None | $114.82 | $162.18 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $134.90 | Professional | None | $67.61 | $131.83 | $134.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $1,479.11 | Facility | None | $144.54 | $234.42 | $1,479.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $239.88 | Professional | None | $120.23 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $257.04 | Facility | None | $100.00 | $181.97 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $229.09 | Professional | None | $112.20 | $177.83 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $323.59 | Professional | None | $114.82 | $186.21 | $323.59 |
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 $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $309.03 | Professional | None | $117.49 | $162.18 | $309.03 |
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 $57.54 Median $72.44 Typical High $81.28 | Professional | 52 · Reduced service | $57.54 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $32.36 | Professional | 53 · Discontinued | $22.91 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $100.00 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $81.28 | $100.00 | $112.20 |
Where Illinois sits
The same service costs 4.1 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· 22nd of 51
$174
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.