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 $758.58 Median $2,137.96 Typical High $7,762.47 | Facility | None | $758.58 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,548.82 | Professional | None | $758.58 | $851.14 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $10,000.00 | Facility | None | $1,905.46 | $3,019.95 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $933.25 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $2,818.38 | Facility | None | $741.31 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,621.81 | Professional | None | $794.33 | $1,174.90 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $7,762.47 | Professional | None | $891.25 | $1,380.38 | $7,762.47 |
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 $1,047.13 Median $1,122.02 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,122.02 | $1,258.93 |
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 $1,047.13 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,454.71 | $6,918.31 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,905.46 | Professional | None | $812.83 | $1,122.02 | $1,905.46 |
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 $380.19 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $562.34 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $616.60 |
Where Illinois sits
The same service costs 7.6 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· 18th of 51
$1,288
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.