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 $1,318.26 Typical High $5,623.41 | Facility | None | $190.55 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $295.12 | Professional | None | $123.03 | $177.83 | $295.12 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,479.11 | Facility | None | $194.98 | $316.23 | $1,479.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $346.74 | Professional | None | $138.04 | $218.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $346.74 | Facility | None | $134.90 | $245.47 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $346.74 | Professional | None | $131.83 | $208.93 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $436.52 | Professional | None | $154.88 | $269.15 | $436.52 |
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 $165.96 Median $169.82 Typical High $275.42 | Professional | None | $165.96 | $169.82 | $275.42 |
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 $138.04 Median $223.87 Typical High $371.54 | Professional | None | $138.04 | $223.87 | $371.54 |
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 $58.88 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $58.88 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $23.44 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $87.10 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $134.90 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$214
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.