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 $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,202.26 | $1,778.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $67,608.30 | Facility | None | $4,570.88 | $7,244.36 | $67,608.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,630.78 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,630.78 | $4,168.69 | $4,897.79 |
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 $1,202.26 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,258.93 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $6,309.57 | Professional | None | $1,288.25 | $1,949.84 | $6,309.57 |
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 $1,479.11 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,479.11 | $1,513.56 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $128.82 Typical High $1,318.26 | Professional | None | $33.11 | $128.82 | $1,318.26 |
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 $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,412.54 | $2,398.83 |
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 $562.34 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $851.14 |
Where Illinois sits
The same service costs 14.5 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· 37th of 51
$1,380
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.