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 $3,311.31 Typical High $9,332.54 | Facility | None | $758.58 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,128.31 Typical High $12,589.25 | Facility | None | $5,495.41 | $8,128.31 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,318.26 | Professional | None | $812.83 | $1,122.02 | $1,318.26 |
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 $741.31 Median $870.96 Typical High $1,202.26 | Professional | None | $741.31 | $870.96 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $2,630.27 | Professional | None | $741.31 | $1,096.48 | $2,630.27 |
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 $812.83 Median $870.96 Typical High $977.24 | Professional | None | $812.83 | $870.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $75.86 Typical High $776.25 | Professional | None | $33.11 | $75.86 | $776.25 |
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 $630.96 Median $758.58 Typical High $1,348.96 | Professional | None | $630.96 | $758.58 | $1,348.96 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $489.78 |
Where Illinois sits
The same service costs 7.8 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
$871
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.