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 $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,995.26 | $2,187.76 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $28,183.83 | Facility | None | $5,754.40 | $8,128.31 | $28,183.83 |
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 $2,238.72 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,238.72 | $2,630.27 | $3,467.37 |
Hally Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,388.44 Typical High $8,511.38 | Professional | None | $2,290.87 | $3,388.44 | $8,511.38 |
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 $2,511.89 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,691.53 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $2,238.72 | Professional | None | $33.11 | $218.78 | $2,238.72 |
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 $1,949.84 Median $2,454.71 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,454.71 | $4,265.80 |
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 $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,513.56 |
Where Illinois sits
The same service costs 21.9 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
$2,570
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.