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 $1,023.29 Median $3,715.35 Typical High $8,912.51 | Facility | None | $1,023.29 | $3,715.35 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,548.13 | $3,890.45 | $3,890.45 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,772.37 Typical High $50,118.72 | Facility | None | $7,079.46 | $9,772.37 | $50,118.72 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,317.64 Typical High $10,471.29 | Facility | None | $776.25 | $8,317.64 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $4,365.16 Typical High $6,456.54 | Professional | None | $3,801.89 | $4,365.16 | $6,456.54 |
Hally Health Setting Professional Modifier None Typical Low $4,073.80 Median $5,888.44 Typical High $12,022.64 | Professional | None | $4,073.80 | $5,888.44 | $12,022.64 |
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 $4,365.16 Median $4,786.30 Typical High $5,370.32 | Professional | None | $4,365.16 | $4,786.30 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $416.87 Typical High $4,265.80 | Professional | None | $33.11 | $416.87 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $7,413.10 | Professional | None | $3,311.31 | $4,073.80 | $7,413.10 |
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 $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,778.28 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,630.27 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,754.23 | $2,754.23 |
Where Illinois sits
The same service costs 20.4 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· 36th of 51
$4,266
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.