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 $398.11 Median $2,630.27 Typical High $7,762.47 | Facility | None | $398.11 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $416.87 | Professional | None | $263.03 | $371.54 | $416.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $5,623.41 | Facility | None | $2,454.71 | $3,467.37 | $5,623.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $660.69 | Professional | None | $316.23 | $478.63 | $660.69 |
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 $363.08 Median $467.74 Typical High $645.65 | Professional | None | $363.08 | $467.74 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,698.24 | Professional | None | $371.54 | $575.44 | $1,698.24 |
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 $338.84 Median $346.74 Typical High $549.54 | Professional | None | $338.84 | $346.74 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $44.67 Typical High $457.09 | Professional | None | $33.11 | $44.67 | $457.09 |
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 $295.12 Median $436.52 Typical High $741.31 | Professional | None | $295.12 | $436.52 | $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 $134.90 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $281.84 |
Where Illinois sits
The same service costs 5.9 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· 29th of 51
$457
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.