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 $630.96 Median $2,630.27 Typical High $7,762.47 | Facility | None | $630.96 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $630.96 | Professional | None | $467.74 | $588.84 | $630.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,165.95 | Facility | None | $2,511.89 | $3,630.78 | $6,165.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,047.13 | Professional | None | $537.03 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $3,715.35 | Facility | None | $891.25 | $3,019.95 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,000.00 | Professional | None | $588.84 | $724.44 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $2,187.76 | Professional | None | $630.96 | $933.25 | $2,187.76 |
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 $588.84 Median $616.60 Typical High $870.96 | Professional | None | $588.84 | $616.60 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $724.44 | Professional | None | $33.11 | $72.44 | $724.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,174.90 | Professional | None | $512.86 | $691.83 | $1,174.90 |
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 $234.42 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $234.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $93.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $354.81 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $46.77 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $446.68 |
Where Illinois sits
The same service costs 5.8 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· 30th of 51
$741
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.