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 $1,698.24 Typical High $5,623.41 | Facility | None | $416.87 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $426.58 | Professional | None | $251.19 | $331.13 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $3,630.78 | Facility | None | $416.87 | $676.08 | $3,630.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $691.83 | Professional | None | $323.59 | $501.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $870.96 | Facility | None | $389.05 | $549.54 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $645.65 | Professional | None | $363.08 | $512.86 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,071.52 | Professional | None | $371.54 | $588.84 | $1,071.52 |
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 $346.74 Median $363.08 Typical High $575.44 | Professional | None | $346.74 | $363.08 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $478.63 | Professional | None | $33.11 | $47.86 | $478.63 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,511.89 | $5,888.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $741.31 | Professional | None | $295.12 | $426.58 | $741.31 |
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 $138.04 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $138.04 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $54.95 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $295.12 |
Where Illinois sits
The same service costs 4.7 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· 27th of 51
$447
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.