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 $870.96 Median $1,905.46 Typical High $7,762.47 | Facility | None | $870.96 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | None | $870.96 | $954.99 | $954.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $22,387.21 | Facility | None | $12,022.64 | $16,982.44 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,982.44 Typical High $21,379.62 | Facility | None | $776.25 | $16,982.44 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,548.82 | Professional | None | $891.25 | $1,000.00 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $4,570.88 | Professional | None | $1,000.00 | $1,479.11 | $4,570.88 |
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 $1,096.48 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,202.26 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $102.33 Typical High $1,071.52 | Professional | None | $33.11 | $102.33 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,819.70 | Professional | None | $776.25 | $933.25 | $1,819.70 |
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 $436.52 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $676.08 |
Where Illinois sits
The same service costs 16.2 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
$1,000
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.