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 $194.98 Median $1,258.93 Typical High $7,762.47 | Facility | None | $194.98 | $1,258.93 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $426.58 | Professional | None | $186.21 | $316.23 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $3,890.45 | Facility | None | $524.81 | $630.96 | $3,890.45 |
BCBS Illinois Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $645.65 | Professional | None | $234.42 | $407.38 | $645.65 |
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 $204.17 Median $323.59 Typical High $616.60 | Professional | None | $204.17 | $323.59 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $794.33 | Professional | None | $234.42 | $467.74 | $794.33 |
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 $263.03 Median $263.03 Typical High $501.19 | Professional | None | $263.03 | $263.03 | $501.19 |
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 $234.42 Median $416.87 Typical High $758.58 | Professional | None | $234.42 | $416.87 | $758.58 |
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 $93.33 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $218.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $218.78 | $245.47 |
Where Illinois sits
The same service costs 4.6 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· 29th of 51
$372
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.