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 $1,621.81 Median $1,949.84 Typical High $5,370.32 | Facility | None | $1,621.81 | $1,949.84 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,698.24 | $1,905.46 | $2,089.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $22,387.21 | Facility | None | $1,479.11 | $2,398.83 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,778.28 Typical High $2,290.87 | Facility | None | $776.25 | $1,778.28 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,511.89 | $3,548.13 |
Hally Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $8,317.64 | Professional | None | $2,137.96 | $3,090.30 | $8,317.64 |
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 $2,089.30 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,238.72 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $2,511.89 | Professional | None | $33.11 | $251.19 | $2,511.89 |
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 $1,949.84 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,454.71 | $3,981.07 |
5 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 $851.14 Median $954.99 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,445.44 |
Where Illinois sits
The same service costs 5.5 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· 35th of 51
$2,344
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.