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 $812.83 Median $2,137.96 Typical High $7,762.47 | Facility | None | $812.83 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | None | $812.83 | $891.25 | $891.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $11,481.54 | Facility | None | $2,511.89 | $3,981.07 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,513.56 | Professional | None | $912.01 | $1,122.02 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,548.13 | Professional | None | $912.01 | $1,380.38 | $3,548.13 |
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 $1,023.29 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,071.52 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $97.72 Typical High $1,047.13 | Professional | None | $33.11 | $97.72 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,621.81 | Professional | None | $758.58 | $933.25 | $1,621.81 |
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 $398.11 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $616.60 |
Where Illinois sits
The same service costs 7.9 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
$1,072
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.