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 $724.44 Median $1,862.09 Typical High $7,762.47 | Facility | None | $724.44 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | None | $660.69 | $724.44 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $12,589.25 | Facility | None | $5,495.41 | $8,317.64 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,348.96 | Professional | None | $831.76 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $776.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,258.93 | Professional | None | $794.33 | $1,071.52 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,454.71 | Professional | None | $758.58 | $1,174.90 | $2,454.71 |
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 $831.76 Median $891.25 Typical High $1,000.00 | Professional | None | $831.76 | $891.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $79.43 Typical High $794.33 | Professional | None | $33.11 | $79.43 | $794.33 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,445.44 | Professional | None | $645.65 | $812.83 | $1,445.44 |
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 $331.13 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 8.7 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· 26th of 51
$1,023
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.