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 $426.58 Median $1,548.82 Typical High $5,623.41 | Facility | None | $426.58 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,025.60 | Facility | None | $2,511.89 | $3,630.78 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,884.03 Typical High $3,715.35 | Facility | None | $478.63 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $741.31 | Professional | None | $436.52 | $478.63 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,659.59 | Professional | None | $457.09 | $676.08 | $1,659.59 |
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 $501.19 Median $537.03 Typical High $602.56 | Professional | None | $501.19 | $537.03 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $489.78 | Professional | None | $33.11 | $47.86 | $489.78 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $812.83 | Professional | None | $380.19 | $467.74 | $812.83 |
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 $194.98 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $302.00 |
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· 37th of 51
$479
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.