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 $436.52 Typical High $4,677.35 | Facility | None | $162.18 | $436.52 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $269.15 | Professional | None | $109.65 | $165.96 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $1,548.82 | Facility | None | $204.17 | $331.13 | $1,548.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $354.81 | Professional | None | $141.25 | $223.87 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $257.04 Typical High $363.08 | Facility | None | $141.25 | $257.04 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $316.23 | Professional | None | $97.72 | $173.78 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $436.52 | Professional | None | $138.04 | $239.88 | $436.52 |
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 $151.36 Median $154.88 Typical High $245.47 | Professional | None | $151.36 | $154.88 | $245.47 |
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 $1,047.13 Typical High $2,951.21 | Facility | None | $446.68 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $354.81 | Professional | None | $125.89 | $199.53 | $354.81 |
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 $79.43 Typical High $85.11 | Professional | 52 · Reduced service | $54.95 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $31.62 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $83.18 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $120.23 |
Where Illinois sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 24th of 51
$209
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.