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 $6,918.31 Median $9,332.54 Typical High $13,489.63 | Facility | None | $6,918.31 | $9,332.54 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,445.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,128.31 Typical High $10,471.29 | Facility | None | $741.31 | $8,128.31 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $933.25 | $1,122.02 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $3,548.13 | Professional | None | $933.25 | $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 $1,047.13 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,096.48 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $1,000.00 | Professional | None | $33.11 | $100.00 | $1,000.00 |
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 $776.25 Median $933.25 Typical High $1,659.59 | Professional | None | $776.25 | $933.25 | $1,659.59 |
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 $407.38 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $407.38 | $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 $616.60 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $134.90 |
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 $575.44 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $630.96 |
Where Illinois sits
The same service costs 8.1 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· 28th of 51
$1,096
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.