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 $338.84 Median $1,258.93 Typical High $7,762.47 | Facility | None | $338.84 | $1,258.93 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $478.63 | Professional | None | $316.23 | $398.11 | $478.63 |
BCBS Illinois Setting Facility Modifier None Typical Low $478.63 Median $776.25 Typical High $5,128.61 | Facility | None | $478.63 | $776.25 | $5,128.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $660.69 | Professional | None | $380.19 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $794.33 | Facility | None | $436.52 | $588.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $831.76 | Professional | None | $354.81 | $501.19 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $1,318.26 | Professional | None | $407.38 | $645.65 | $1,318.26 |
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 $446.68 Median $457.09 Typical High $645.65 | Professional | None | $446.68 | $457.09 | $645.65 |
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 $3,981.07 | Facility | None | $446.68 | $1,047.13 | $3,981.07 |
United Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $977.24 | Professional | None | $407.38 | $616.60 | $977.24 |
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 $158.49 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $158.49 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $239.88 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $309.03 |
Where Illinois sits
The same service costs 5.1 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
$550
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.