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 $3,019.95 Median $3,311.31 Typical High $16,595.87 | Facility | None | $3,019.95 | $3,311.31 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,951.21 | $3,311.31 | $3,311.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $6,760.83 | Facility | None | $2,238.72 | $3,311.31 | $6,760.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,047.13 | Professional | None | $630.96 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,630.27 Typical High $3,311.31 | Facility | None | $776.25 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $8,128.31 Typical High $10,232.93 | Professional | None | $3,630.78 | $8,128.31 | $10,232.93 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $5,248.07 | Professional | None | $549.54 | $831.76 | $5,248.07 |
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 $630.96 Median $645.65 Typical High $707.95 | Professional | None | $630.96 | $645.65 | $707.95 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,995.26 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $6,165.95 | Professional | None | $1,778.28 | $2,951.21 | $6,165.95 |
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 $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,479.11 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,290.87 | $2,290.87 |
Where Illinois sits
The same service costs 21.4 times more in Alaska than in Kentucky. 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· 25th of 51
$3,311
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.