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 $977.24 Median $3,388.44 Typical High $10,232.93 | Facility | None | $977.24 | $3,388.44 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $13,489.63 | Facility | None | $7,079.46 | $9,332.54 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,513.56 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $8,128.31 Typical High $10,471.29 | Facility | None | $1,023.29 | $8,128.31 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,230.27 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $4,365.16 | Professional | None | $1,023.29 | $1,548.82 | $4,365.16 |
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 $1,122.02 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,202.26 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $104.71 Typical High $1,071.52 | Professional | None | $33.11 | $104.71 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,949.84 | Professional | None | $870.96 | $1,071.52 | $1,949.84 |
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 $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $676.08 |
Where Illinois sits
The same service costs 7.9 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
$1,230
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.