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 $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,288.25 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $7,943.28 Typical High $16,982.44 | Facility | None | $5,754.40 | $7,943.28 | $16,982.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,698.24 | $2,344.23 |
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 $1,258.93 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,318.26 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $5,128.61 | Professional | None | $1,380.38 | $2,041.74 | $5,128.61 |
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 $1,513.56 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,621.81 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $134.90 Typical High $1,380.38 | Professional | None | $33.11 | $134.90 | $1,380.38 |
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 $1,174.90 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,412.54 | $2,511.89 |
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 $588.84 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $912.01 |
Where Illinois sits
The same service costs 17.8 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· 39th 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.