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 $1,096.48 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,096.48 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,698.24 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,125.38 Median $18,197.01 Typical High $24,547.09 | Facility | None | $14,125.38 | $18,197.01 | $24,547.09 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,982.44 Typical High $21,379.62 | Facility | None | $776.25 | $16,982.44 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,905.46 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $6,309.57 | Professional | None | $1,778.28 | $2,691.53 | $6,309.57 |
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 $1,905.46 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,089.30 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $1,819.70 | Professional | None | $33.11 | $181.97 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $22,908.68 | Facility | None | $1,659.59 | $7,585.78 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,548.82 | $1,905.46 | $3,311.31 |
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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 17.0 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
$1,905
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.