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 $1,862.09 Typical High $5,623.41 | Facility | None | $758.58 | $1,862.09 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $933.25 | Professional | None | $707.95 | $851.14 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $10,000.00 | Facility | None | $1,000.00 | $1,621.81 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,905.46 | Professional | None | $891.25 | $1,258.93 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,548.82 | Facility | None | $630.96 | $1,202.26 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $776.25 Typical High $1,445.44 | Professional | None | $316.23 | $776.25 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $1,230.27 Typical High $1,659.59 | Professional | None | $562.34 | $1,230.27 | $1,659.59 |
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 $912.01 Median $933.25 Typical High $1,230.27 | Professional | None | $912.01 | $933.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $109.65 Typical High $1,096.48 | Professional | None | $33.11 | $109.65 | $1,096.48 |
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 $575.44 Median $758.58 Typical High $1,548.82 | Professional | None | $575.44 | $758.58 | $1,548.82 |
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 $354.81 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $524.81 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $660.69 |
Where Illinois sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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· 32nd of 51
$891
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.