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 $213.80 Median $1,698.24 Typical High $5,623.41 | Facility | None | $213.80 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $234.42 | Professional | None | $123.03 | $147.91 | $234.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $2,818.38 | Facility | None | $239.88 | $389.05 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $371.54 | Professional | None | $173.78 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $524.81 | Facility | None | $229.09 | $323.59 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $346.74 | Professional | None | $190.55 | $245.47 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $512.86 | Professional | None | $190.55 | $302.00 | $512.86 |
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 $177.83 Median $186.21 Typical High $295.12 | Professional | None | $177.83 | $186.21 | $295.12 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $371.54 | Professional | None | $144.54 | $199.53 | $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 $70.79 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $107.15 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $21.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $100.00 | $128.82 | $147.91 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 27th of 51
$234
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.