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 $524.81 Median $1,778.28 Typical High $5,623.41 | Facility | None | $524.81 | $1,778.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $575.44 | Professional | None | $323.59 | $489.78 | $575.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $4,570.88 | Facility | None | $1,778.28 | $2,290.87 | $4,570.88 |
BCBS Illinois Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,023.29 | Professional | None | $436.52 | $707.95 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $2,630.27 | Facility | None | $630.96 | $2,089.30 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $933.25 | Professional | None | $407.38 | $524.81 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $1,778.28 | Professional | None | $436.52 | $758.58 | $1,778.28 |
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 $426.58 Median $446.68 Typical High $794.33 | Professional | None | $426.58 | $446.68 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $707.95 | Professional | None | $33.11 | $70.79 | $707.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $1,000.00 | Professional | None | $309.03 | $512.86 | $1,000.00 |
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 $169.82 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $67.61 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $257.04 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.88 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $239.88 | $346.74 | $407.38 |
Where Illinois sits
The same service costs 4.7 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· 25th of 51
$589
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.