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 $316.23 Median $1,288.25 Typical High $5,623.41 | Facility | None | $316.23 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $501.19 | Professional | None | $239.88 | $295.12 | $501.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $2,951.21 | Facility | None | $316.23 | $501.19 | $2,951.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $588.84 | Professional | None | $288.40 | $407.38 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $660.69 | Facility | None | $295.12 | $416.87 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $602.56 | Professional | None | $295.12 | $398.11 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $851.14 | Professional | None | $316.23 | $467.74 | $851.14 |
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 $331.13 Median $346.74 Typical High $467.74 | Professional | None | $331.13 | $346.74 | $467.74 |
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 $263.03 Median $407.38 Typical High $616.60 | Professional | None | $263.03 | $407.38 | $616.60 |
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 $117.49 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $218.78 |
Where Illinois sits
The same service costs 4.7 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
$398
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.