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 $776.25 Median $2,137.96 Typical High $7,762.47 | Facility | None | $776.25 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,412.54 | Professional | None | $776.25 | $870.96 | $1,412.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $10,232.93 | Facility | None | $1,698.24 | $2,630.27 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,230.27 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $2,570.40 | Facility | None | $741.31 | $2,041.74 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,621.81 | Professional | None | $891.25 | $1,202.26 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $3,019.95 | Professional | None | $912.01 | $1,412.54 | $3,019.95 |
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 $1,071.52 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,148.15 | $1,288.25 |
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 $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,949.84 | Professional | None | $812.83 | $1,148.15 | $1,949.84 |
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 $389.05 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $630.96 |
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· 16th of 51
$1,318
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.