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 $416.87 Median $1,548.82 Typical High $5,623.41 | Facility | None | $416.87 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | None | $380.19 | $416.87 | $416.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,025.60 | Facility | None | $2,511.89 | $3,630.78 | $6,025.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $812.83 | Professional | None | $501.19 | $691.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,884.03 Typical High $3,715.35 | Facility | None | $478.63 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $724.44 | Professional | None | $416.87 | $457.09 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,995.26 | Professional | None | $446.68 | $676.08 | $1,995.26 |
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 $501.19 Median $524.81 Typical High $588.84 | Professional | None | $501.19 | $524.81 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $46.77 Typical High $524.81 | Professional | None | $33.11 | $46.77 | $524.81 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $776.25 | Professional | None | $371.54 | $446.68 | $776.25 |
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 $190.55 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $295.12 |
Where Illinois sits
The same service costs 8.1 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
$479
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.