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 $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,122.02 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $14,791.08 | Facility | None | $7,079.46 | $9,332.54 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,317.64 Typical High $10,471.29 | Facility | None | $776.25 | $8,317.64 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,258.93 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $5,248.07 | Professional | None | $1,174.90 | $1,737.80 | $5,248.07 |
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 $1,288.25 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,412.54 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $123.03 Typical High $1,230.27 | Professional | None | $33.11 | $123.03 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,137.96 | Professional | None | $977.24 | $1,202.26 | $2,137.96 |
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 $512.86 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Where Illinois sits
The same service costs 13.8 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· 32nd of 51
$1,259
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.