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 $446.68 Median $1,737.80 Typical High $5,623.41 | Facility | None | $446.68 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $489.78 | Professional | None | $275.42 | $363.08 | $489.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,122.02 | $1,737.80 | $3,890.45 |
BCBS Illinois Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $724.44 | Professional | None | $354.81 | $537.03 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $1,737.80 | Facility | None | $630.96 | $1,348.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $676.08 | Professional | None | $380.19 | $478.63 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $1,122.02 | Professional | None | $398.11 | $616.60 | $1,122.02 |
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 $380.19 Median $389.05 Typical High $602.56 | Professional | None | $380.19 | $389.05 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $512.86 | Professional | None | $33.11 | $50.12 | $512.86 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $794.33 | Professional | None | $323.59 | $457.09 | $794.33 |
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 $151.36 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $151.36 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $223.87 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $208.93 | $269.15 | $309.03 |
Where Illinois sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 30th 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.