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 $645.65 Median $1,905.46 Typical High $5,888.44 | Facility | None | $645.65 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | None | $588.84 | $645.65 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $8,317.64 | Facility | None | $1,318.26 | $2,041.74 | $8,317.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,230.27 | Professional | None | $758.58 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,584.89 Typical High $1,995.26 | Facility | None | $630.96 | $1,584.89 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,096.48 | Professional | None | $478.63 | $645.65 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $2,511.89 | Professional | None | $616.60 | $1,023.29 | $2,511.89 |
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 $758.58 Median $812.83 Typical High $912.01 | Professional | None | $758.58 | $812.83 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $758.58 | Professional | None | $33.11 | $70.79 | $758.58 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,230.27 | Professional | None | $537.03 | $691.83 | $1,230.27 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $457.09 |
Where Illinois sits
The same service costs 7.4 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· 31st of 51
$724
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.