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 $977.24 Median $3,311.31 Typical High $9,332.54 | Facility | None | $977.24 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | None | $977.24 | $1,071.52 | $1,071.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,943.28 Median $10,232.93 Typical High $13,803.84 | Facility | None | $7,943.28 | $10,232.93 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $9,120.11 Typical High $11,748.98 | Facility | None | $1,023.29 | $9,120.11 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,318.26 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,122.02 | $1,698.24 | $3,981.07 |
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 $1,230.27 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,318.26 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $114.82 Typical High $1,202.26 | Professional | None | $33.11 | $114.82 | $1,202.26 |
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 $954.99 Median $1,174.90 Typical High $2,041.74 | Professional | None | $954.99 | $1,174.90 | $2,041.74 |
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 $478.63 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $741.31 |
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· 33rd of 51
$1,288
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.