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 $630.96 Median $1,621.81 Typical High $5,623.41 | Facility | None | $630.96 | $1,621.81 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | None | $616.60 | $691.83 | $691.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,890.45 Typical High $8,912.51 | Facility | None | $2,511.89 | $3,890.45 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,884.03 Typical High $3,715.35 | Facility | None | $478.63 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,148.15 | Professional | None | $724.44 | $891.25 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $2,344.23 | Professional | None | $707.95 | $1,071.52 | $2,344.23 |
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 $794.33 Median $831.76 Typical High $933.25 | Professional | None | $794.33 | $831.76 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $776.25 | Professional | None | $33.11 | $77.62 | $776.25 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,230.27 | Professional | None | $575.44 | $707.95 | $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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where Illinois sits
The same service costs 7.8 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· 25th of 51
$871
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.