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 $933.25 Median $3,311.31 Typical High $7,762.47 | Facility | None | $933.25 | $3,311.31 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,311.31 | $3,311.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $20,892.96 Median $25,118.86 Typical High $43,651.58 | Facility | None | $20,892.96 | $25,118.86 | $43,651.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $24,547.09 Typical High $31,622.78 | Facility | None | $758.58 | $24,547.09 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,623.41 | Professional | None | $3,467.37 | $4,073.80 | $5,623.41 |
Hally Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,248.07 Typical High $11,481.54 | Professional | None | $3,548.13 | $5,248.07 | $11,481.54 |
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 $3,801.89 Median $4,168.69 Typical High $4,677.35 | Professional | None | $3,801.89 | $4,168.69 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $354.81 Typical High $3,630.78 | Professional | None | $33.11 | $354.81 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $25,703.96 | Facility | None | $1,659.59 | $7,585.78 | $25,703.96 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,630.78 | $6,606.93 |
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 $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,513.56 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,290.87 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,344.23 | $2,344.23 |
Where Illinois sits
The same service costs 20.4 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· 29th of 51
$3,981
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.