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 $977.24 Median $3,311.31 Typical High $9,332.54 | Facility | None | $977.24 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $933.25 | $1,023.29 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,232.93 Median $13,803.84 Typical High $21,877.62 | Facility | None | $10,232.93 | $13,803.84 | $21,877.62 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $12,022.64 Typical High $15,135.61 | Facility | None | $1,023.29 | $12,022.64 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,174.90 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $3,890.45 | Professional | None | $1,096.48 | $1,621.81 | $3,890.45 |
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 $1,174.90 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,288.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $112.20 Typical High $1,122.02 | Professional | None | $33.11 | $112.20 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $16,982.44 | Facility | None | $1,479.11 | $5,011.87 | $16,982.44 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,995.26 | Professional | None | $933.25 | $1,148.15 | $1,995.26 |
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 $467.74 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $724.44 | $724.44 |
Where Illinois sits
The same service costs 8.5 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
$1,175
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.