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 $933.25 Median $3,235.94 Typical High $7,762.47 | Facility | None | $933.25 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $12,589.25 | Facility | None | $2,511.89 | $3,981.07 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $3,715.35 | Facility | None | $891.25 | $3,019.95 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,412.54 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,047.13 | $1,584.89 | $4,168.69 |
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 $1,122.02 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,230.27 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $1,071.52 | Professional | None | $33.11 | $107.15 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,995.26 | Professional | None | $851.14 | $1,047.13 | $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 $446.68 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $691.83 |
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· 27th of 51
$1,349
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.