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 $812.83 Median $3,311.31 Typical High $9,332.54 | Facility | None | $812.83 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $12,589.25 | Facility | None | $5,495.41 | $8,317.64 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,548.82 | Professional | None | $954.99 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $8,317.64 | Facility | None | $1,023.29 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,380.38 | Professional | None | $870.96 | $1,023.29 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $3,090.30 | Professional | None | $870.96 | $1,288.25 | $3,090.30 |
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 $954.99 Median $1,023.29 Typical High $1,148.15 | Professional | None | $954.99 | $1,023.29 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $977.24 | Professional | None | $33.11 | $89.13 | $977.24 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,584.89 | Professional | None | $741.31 | $891.25 | $1,584.89 |
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 $371.54 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $575.44 |
Where Illinois sits
The same service costs 7.4 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· 32nd of 51
$1,000
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.