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 $123.03 Median $1,202.26 Typical High $7,762.47 | Facility | None | $123.03 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $208.93 | Professional | None | $114.82 | $190.55 | $208.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $2,454.71 | Facility | None | $257.04 | $309.03 | $2,454.71 |
BCBS Illinois Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $398.11 | Professional | None | $144.54 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $380.19 | Professional | None | $141.25 | $199.53 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $524.81 | Professional | None | $162.18 | $288.40 | $524.81 |
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 $162.18 Median $169.82 Typical High $302.00 | Professional | None | $162.18 | $169.82 | $302.00 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $416.87 | Professional | None | $134.90 | $234.42 | $416.87 |
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 $56.23 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $56.23 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $85.11 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $79.43 | $128.82 | $147.91 |
Where Illinois sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 25th of 51
$224
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.