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 $45.71 Median $1,202.26 Typical High $7,762.47 | Facility | None | $45.71 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $57.54 | Professional | None | $41.69 | $45.71 | $57.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $912.01 | Facility | None | $75.86 | $91.20 | $912.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $91.20 | Professional | None | $51.29 | $63.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $93.33 | Professional | None | $44.67 | $64.57 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $131.83 | Professional | None | $52.48 | $77.62 | $131.83 |
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 $58.88 Median $61.66 Typical High $70.79 | Professional | None | $58.88 | $61.66 | $70.79 |
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 $138.04 Median $457.09 Typical High $1,819.70 | Facility | None | $138.04 | $457.09 | $1,819.70 |
United Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $104.71 | Professional | None | $44.67 | $63.10 | $104.71 |
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 $20.89 Median $22.91 Typical High $24.55 | Professional | 52 · Reduced service | $20.89 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.12 Typical High $9.77 | Professional | 53 · Discontinued | $8.32 | $9.12 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $34.67 Typical High $37.15 | Professional | 54 · Surgery only | $30.90 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.92 Typical High $7.41 | Professional | 55 · Aftercare only | $6.31 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.57 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.17 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $32.36 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $28.84 | $32.36 | $34.67 |
Where Illinois sits
The same service costs 4.6 times more in Alaska than in New York. 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· 23rd of 51
$63.10
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.