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 $281.84 Median $1,698.24 Typical High $5,623.41 | Facility | None | $281.84 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $295.12 | Professional | None | $181.97 | $239.88 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $3,388.44 | Facility | None | $288.40 | $457.09 | $3,388.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $416.87 | Professional | None | $213.80 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $457.09 | Facility | None | $194.98 | $354.81 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $489.78 | Professional | None | $218.78 | $295.12 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $691.83 | Professional | None | $218.78 | $371.54 | $691.83 |
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 $223.87 Median $234.42 Typical High $389.05 | Professional | None | $223.87 | $234.42 | $389.05 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $524.81 | Professional | None | $190.55 | $295.12 | $524.81 |
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 $91.20 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $91.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $44.67 Typical High $56.23 | Professional | 53 · Discontinued | $36.31 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.39 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.20 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $154.88 | $199.53 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$309
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.