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 $741.31 Median $3,019.95 Typical High $9,120.11 | Facility | None | $741.31 | $3,019.95 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $954.99 | Professional | None | $616.60 | $758.58 | $954.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,232.93 | Facility | None | $4,570.88 | $6,760.83 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,548.82 | Professional | None | $676.08 | $1,000.00 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,023.29 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,230.27 | Professional | None | $537.03 | $645.65 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $3,019.95 | Professional | None | $691.83 | $1,047.13 | $3,019.95 |
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 $724.44 Median $741.31 Typical High $1,047.13 | Professional | None | $724.44 | $741.31 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $912.01 | Professional | None | $33.11 | $89.13 | $912.01 |
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 $616.60 Median $831.76 Typical High $1,412.54 | Professional | None | $616.60 | $831.76 | $1,412.54 |
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 $302.00 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $562.34 |
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
$813
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.