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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,659.59 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $43,651.58 | Facility | None | $5,754.40 | $8,128.31 | $43,651.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $6,760.83 | Professional | None | $5,888.44 | $6,165.95 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,760.83 Typical High $8,709.64 | Facility | None | $776.25 | $6,760.83 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,737.80 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $10,471.29 | Professional | None | $1,737.80 | $2,691.53 | $10,471.29 |
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 $2,041.74 Median $2,089.30 Typical High $2,290.87 | Professional | None | $2,041.74 | $2,089.30 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $177.83 Typical High $1,819.70 | Professional | None | $33.11 | $177.83 | $1,819.70 |
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 $1,513.56 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,862.09 | $3,311.31 |
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 $776.25 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $776.25 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 18.2 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· 36th of 51
$1,905
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.