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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $12,022.64 | Facility | None | $4,570.88 | $6,760.83 | $12,022.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,412.54 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $776.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,548.82 | Professional | None | $933.25 | $977.24 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $11,748.98 | Professional | None | $977.24 | $1,445.44 | $11,748.98 |
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 $1,071.52 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,148.15 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $97.72 Typical High $1,000.00 | Professional | None | $33.11 | $97.72 | $1,000.00 |
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 $851.14 Median $1,000.00 Typical High $1,819.70 | Professional | None | $851.14 | $1,000.00 | $1,819.70 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $645.65 |
Where Illinois sits
The same service costs 20.0 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· 33rd of 51
$1,047
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.