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 $645.65 Median $1,862.09 Typical High $5,623.41 | Facility | None | $645.65 | $1,862.09 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | None | $645.65 | $724.44 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,232.93 | Facility | None | $4,570.88 | $6,760.83 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,380.38 | Professional | None | $758.58 | $1,023.29 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,760.83 | Facility | None | $630.96 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,348.96 | Professional | None | $707.95 | $758.58 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $2,344.23 | Professional | None | $776.25 | $1,122.02 | $2,344.23 |
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 $812.83 Median $831.76 Typical High $1,071.52 | Professional | None | $812.83 | $831.76 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $954.99 | Professional | None | $33.11 | $95.50 | $954.99 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,445.44 | Professional | None | $707.95 | $912.01 | $1,445.44 |
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 $323.59 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $537.03 |
Where Illinois sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 32nd of 51
$933
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.