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 $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $18,197.01 | Facility | None | $2,511.89 | $3,981.07 | $18,197.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,238.72 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $3,715.35 | Facility | None | $891.25 | $3,019.95 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,479.11 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $7,943.28 | Professional | None | $1,380.38 | $2,187.76 | $7,943.28 |
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 $1,621.81 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,737.80 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $154.88 Typical High $1,548.82 | Professional | None | $33.11 | $154.88 | $1,548.82 |
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 $1,202.26 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,445.44 | $2,630.27 |
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 $645.65 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $977.24 |
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
$1,622
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.