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 $245.47 Median $1,348.96 Typical High $5,623.41 | Facility | None | $245.47 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | None | $223.87 | $245.47 | $245.47 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,162.28 | Facility | None | $1,318.26 | $1,949.84 | $3,162.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $537.03 | Professional | None | $302.00 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $1,949.84 | Facility | None | $478.63 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $446.68 | Professional | None | $208.93 | $275.42 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $891.25 | Professional | None | $257.04 | $380.19 | $891.25 |
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 $295.12 Median $309.03 Typical High $346.74 | Professional | None | $295.12 | $309.03 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $309.03 | Professional | None | $33.11 | $33.11 | $309.03 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $446.68 | Professional | None | $213.80 | $251.19 | $446.68 |
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 $112.20 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $181.97 Typical High $186.21 | Professional | 54 · Surgery only | $165.96 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $169.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $154.88 | $169.82 | $173.78 |
Where Illinois sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$275
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.