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 $257.04 Median $1,318.26 Typical High $5,623.41 | Facility | None | $257.04 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $257.04 | Professional | None | $158.49 | $218.78 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,884.03 | Facility | None | $281.84 | $446.68 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $512.86 | Professional | None | $181.97 | $295.12 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $537.03 | Facility | None | $263.03 | $371.54 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $389.05 | Professional | None | $194.98 | $269.15 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $588.84 | Professional | None | $208.93 | $346.74 | $588.84 |
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 $194.98 Median $204.17 Typical High $346.74 | Professional | None | $194.98 | $204.17 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
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 $162.18 Median $245.47 Typical High $436.52 | Professional | None | $162.18 | $245.47 | $436.52 |
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 $79.43 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $31.62 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $117.49 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $23.44 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $109.65 | $151.36 | $177.83 |
Where Illinois sits
The same service costs 3.7 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· 30th of 51
$257
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.