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 $9,332.54 | Facility | None | $1,023.29 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $15,848.93 | Facility | None | $7,079.46 | $9,332.54 | $15,848.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,905.46 | $2,238.72 |
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 $1,288.25 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,548.82 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,288.25 | $1,949.84 | $4,570.88 |
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 $1,380.38 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,513.56 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $128.82 Typical High $1,318.26 | Professional | None | $33.11 | $128.82 | $1,318.26 |
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 $1,122.02 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,380.38 | $2,454.71 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $851.14 |
Where Illinois sits
The same service costs 8.7 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
$1,514
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.