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 $758.58 Median $3,311.31 Typical High $14,125.38 | Facility | None | $758.58 | $3,311.31 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $912.01 | Professional | None | $645.65 | $741.31 | $912.01 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $8,317.64 | Facility | None | $1,000.00 | $1,621.81 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,258.93 | Professional | None | $676.08 | $776.25 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,630.27 | Professional | None | $758.58 | $1,122.02 | $2,630.27 |
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 $758.58 Median $812.83 Typical High $1,096.48 | Professional | None | $758.58 | $812.83 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $912.01 | Professional | None | $33.11 | $91.20 | $912.01 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,380.38 | Professional | None | $630.96 | $831.76 | $1,380.38 |
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 $309.03 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $562.34 |
Where Illinois sits
The same service costs 5.6 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
$794
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.