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 $1,202.26 Median $1,445.44 Typical High $3,981.07 | Facility | None | $1,202.26 | $1,445.44 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,412.54 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $16,218.10 | Facility | None | $1,096.48 | $1,778.28 | $16,218.10 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,412.54 | $2,041.74 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,737.80 | Facility | None | $758.58 | $1,348.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,819.70 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $6,165.95 | Professional | None | $1,584.89 | $2,290.87 | $6,165.95 |
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 $1,548.82 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,621.81 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $186.21 Typical High $1,862.09 | Professional | None | $33.11 | $186.21 | $1,862.09 |
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 $1,445.44 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,819.70 | $2,951.21 |
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 $630.96 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,071.52 |
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· 34th of 51
$1,778
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.