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 $87.10 Median $1,202.26 Typical High $7,762.47 | Facility | None | $87.10 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $169.82 | Professional | None | $87.10 | $104.71 | $169.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $1,698.24 | Facility | None | $575.44 | $645.65 | $1,698.24 |
BCBS Illinois Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $169.82 | Professional | None | $83.18 | $120.23 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $812.83 | Facility | None | $50.12 | $251.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $154.88 | Professional | None | $75.86 | $102.33 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $295.12 | Professional | None | $75.86 | $125.89 | $295.12 |
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 $95.50 Median $95.50 Typical High $123.03 | Professional | None | $95.50 | $95.50 | $123.03 |
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 $89.13 Median $123.03 Typical High $194.98 | Professional | None | $89.13 | $123.03 | $194.98 |
7 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 $38.90 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $38.90 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.62 Typical High $21.38 | Professional | 53 · Discontinued | $15.49 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $70.79 Typical High $79.43 | Professional | 54 · Surgery only | $58.88 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $15.85 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $66.07 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $54.95 | $66.07 | $74.13 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 50 · Both sides | $131.83 | $131.83 | $131.83 |
Where Illinois sits
The same service costs 4.2 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· 29th of 51
$120
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.