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 $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,445.44 | $1,445.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,549.93 Typical High $18,620.87 | Facility | None | $7,079.46 | $9,549.93 | $18,620.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,621.81 | $2,238.72 | $2,630.27 |
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 $1,412.54 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,621.81 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $6,760.83 | Professional | None | $1,513.56 | $2,238.72 | $6,760.83 |
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 $1,778.28 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,778.28 | $1,995.26 |
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 $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,584.89 | $2,818.38 |
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 $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,000.00 |
Where Illinois sits
The same service costs 18.6 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· 34th 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.