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 $851.14 Median $3,235.94 Typical High $7,762.47 | Facility | None | $851.14 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $13,182.57 | Facility | None | $5,495.41 | $8,317.64 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,456.54 Typical High $8,317.64 | Facility | None | $891.25 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,479.11 | Professional | None | $851.14 | $954.99 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $3,235.94 | Professional | None | $912.01 | $1,348.96 | $3,235.94 |
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 $977.24 Median $1,071.52 Typical High $1,202.26 | Professional | None | $977.24 | $1,071.52 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $93.33 Typical High $954.99 | Professional | None | $33.11 | $93.33 | $954.99 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,659.59 | Professional | None | $758.58 | $933.25 | $1,659.59 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $602.56 |
Where Illinois sits
The same service costs 7.6 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· 34th 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.