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 $1,096.48 Median $3,715.35 Typical High $10,232.93 | Facility | None | $1,096.48 | $3,715.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,905.46 | $2,187.76 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,125.38 Median $18,197.01 Typical High $28,183.83 | Facility | None | $14,125.38 | $18,197.01 | $28,183.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,982.44 Typical High $21,379.62 | Facility | None | $776.25 | $16,982.44 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,041.74 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,235.94 Typical High $6,918.31 | Professional | None | $2,238.72 | $3,235.94 | $6,918.31 |
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 $2,187.76 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,630.27 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $2,570.40 | Professional | None | $33.11 | $257.04 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $22,908.68 | Facility | None | $1,659.59 | $7,585.78 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,290.87 | $4,073.80 |
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 $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $933.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $380.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,412.54 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,513.56 | $1,513.56 |
Where Illinois sits
The same service costs 16.2 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· 35th of 51
$2,291
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.