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 $831.76 Median $2,238.72 Typical High $7,762.47 | Facility | None | $831.76 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | None | $954.99 | $1,047.13 | $1,047.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,623.41 | $8,317.64 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $8,317.64 | Facility | None | $741.31 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,445.44 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $4,897.79 | Professional | None | $1,096.48 | $1,659.59 | $4,897.79 |
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 $1,202.26 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,288.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $112.20 Typical High $1,148.15 | Professional | None | $33.11 | $112.20 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,089.30 | Professional | None | $933.25 | $1,174.90 | $2,089.30 |
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 $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $724.44 |
Where Illinois sits
The same service costs 8.3 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
$1,413
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.