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 $190.55 Median $1,202.26 Typical High $7,762.47 | Facility | None | $190.55 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $354.81 | Professional | None | $181.97 | $269.15 | $354.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $954.99 Median $1,096.48 Typical High $3,801.89 | Facility | None | $954.99 | $1,096.48 | $3,801.89 |
BCBS Illinois Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $549.54 | Professional | None | $229.09 | $354.81 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $812.83 | Facility | None | $50.12 | $251.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $562.34 | Professional | None | $169.82 | $316.23 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $831.76 | Professional | None | $223.87 | $416.87 | $831.76 |
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 $257.04 Median $257.04 Typical High $436.52 | Professional | None | $257.04 | $257.04 | $436.52 |
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 $239.88 Median $407.38 Typical High $707.95 | Professional | None | $239.88 | $407.38 | $707.95 |
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 $89.13 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $89.13 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $53.70 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $190.55 | $213.80 |
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
$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.