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 $602.56 Median $1,819.70 Typical High $5,623.41 | Facility | None | $602.56 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $851.14 | Professional | None | $575.44 | $630.96 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $7,413.10 | Facility | None | $1,000.00 | $1,621.81 | $7,413.10 |
BCBS Illinois Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,380.38 | Professional | None | $691.83 | $1,096.48 | $1,380.38 |
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 $331.13 Median $602.56 Typical High $1,122.02 | Professional | None | $331.13 | $602.56 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $2,754.23 | Professional | None | $524.81 | $954.99 | $2,754.23 |
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 $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $794.33 | Professional | None | $33.11 | $77.62 | $794.33 |
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 $537.03 Median $691.83 Typical High $1,202.26 | Professional | None | $537.03 | $691.83 | $1,202.26 |
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 $281.84 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $478.63 |
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· 33rd of 51
$692
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.