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 $1,000.00 Median $2,754.23 Typical High $8,128.31 | Facility | None | $1,000.00 | $2,754.23 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | None | $912.01 | $1,000.00 | $1,000.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,623.41 | $8,317.64 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,548.82 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $891.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,148.15 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,584.89 | $3,715.35 |
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 $1,148.15 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,230.27 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $1,096.48 | Professional | None | $33.11 | $107.15 | $1,096.48 |
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 $891.25 Median $1,096.48 Typical High $1,949.84 | Professional | None | $891.25 | $1,096.48 | $1,949.84 |
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 $446.68 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $691.83 |
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· 34th of 51
$1,148
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.