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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | None | $588.84 | $645.65 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $12,302.69 | Facility | None | $5,495.41 | $7,762.47 | $12,302.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,230.27 | Professional | None | $758.58 | $1,023.29 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $891.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,096.48 | Professional | None | $645.65 | $758.58 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $2,454.71 | Professional | None | $691.83 | $1,023.29 | $2,454.71 |
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 $741.31 Median $812.83 Typical High $891.25 | Professional | None | $741.31 | $812.83 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $724.44 | Professional | None | $33.11 | $70.79 | $724.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,258.93 | Professional | None | $575.44 | $707.95 | $1,258.93 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 8.3 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· 33rd of 51
$759
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.