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 $794.33 Median $2,137.96 Typical High $7,762.47 | Facility | None | $794.33 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $11,481.54 | Facility | None | $3,162.28 | $4,365.16 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $4,677.35 | Facility | None | $741.31 | $3,715.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,513.56 | Professional | None | $870.96 | $954.99 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $3,311.31 | Professional | None | $933.25 | $1,380.38 | $3,311.31 |
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 $1,000.00 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,096.48 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $954.99 | Professional | None | $33.11 | $95.50 | $954.99 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,698.24 | Professional | None | $794.33 | $977.24 | $1,698.24 |
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 $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $616.60 |
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· 35th of 51
$955
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.