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 $724.44 Median $3,235.94 Typical High $9,772.37 | Facility | None | $724.44 | $3,235.94 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $660.69 | Professional | None | $575.44 | $645.65 | $660.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $8,317.64 | Facility | None | $1,318.26 | $2,041.74 | $8,317.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,230.27 | Professional | None | $758.58 | $1,023.29 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,884.03 | Facility | None | $891.25 | $1,621.81 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,071.52 | Professional | None | $575.44 | $645.65 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $3,311.31 | Professional | None | $676.08 | $1,000.00 | $3,311.31 |
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 $741.31 Median $794.33 Typical High $891.25 | Professional | None | $741.31 | $794.33 | $891.25 |
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 $1,174.90 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,235.94 | $7,762.47 |
United Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,202.26 | Professional | None | $575.44 | $676.08 | $1,202.26 |
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 $288.40 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 7.2 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· 34th of 51
$759
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.