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 $616.60 Median $3,311.31 Typical High $14,125.38 | Facility | None | $616.60 | $3,311.31 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $776.25 | Professional | None | $524.81 | $602.56 | $776.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $6,760.83 | Facility | None | $3,235.94 | $4,265.80 | $6,760.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,288.25 | Professional | None | $588.84 | $812.83 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $3,890.45 Typical High $4,897.79 | Facility | None | $1,380.38 | $3,890.45 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Professional | None | $562.34 | $676.08 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $4,168.69 | Professional | None | $630.96 | $891.25 | $4,168.69 |
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 $645.65 Median $660.69 Typical High $851.14 | Professional | None | $645.65 | $660.69 | $851.14 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $794.33 | Professional | None | $33.11 | $72.44 | $794.33 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | None | $588.84 | $758.58 | $1,202.26 |
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 $257.04 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $436.52 |
Where Illinois sits
The same service costs 6.2 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
$724
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.