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 $501.19 Median $1,949.84 Typical High $6,165.95 | Facility | None | $501.19 | $1,949.84 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $501.19 | Professional | None | $316.23 | $436.52 | $501.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,621.81 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,548.82 | Facility | None | $707.95 | $1,230.27 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $812.83 | Professional | None | $275.42 | $354.81 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,548.82 | Professional | None | $371.54 | $660.69 | $1,548.82 |
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 $398.11 Median $416.87 Typical High $691.83 | Professional | None | $398.11 | $416.87 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $61.66 Typical High $616.60 | Professional | None | $33.11 | $61.66 | $616.60 |
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 $302.00 Median $467.74 Typical High $891.25 | Professional | None | $302.00 | $467.74 | $891.25 |
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 $158.49 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $158.49 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $239.88 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $223.87 | $302.00 | $354.81 |
Where Illinois sits
The same service costs 5.1 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
$468
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.