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 $1,148.15 Median $3,890.45 Typical High $14,125.38 | Facility | None | $1,148.15 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,819.70 | $2,754.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $21,379.62 | Facility | None | $4,570.88 | $7,244.36 | $21,379.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,630.27 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $5,495.41 Typical High $6,760.83 | Facility | None | $1,862.09 | $5,495.41 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,862.09 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $10,232.93 | Professional | None | $1,584.89 | $2,511.89 | $10,232.93 |
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 $1,862.09 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,995.26 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,041.74 | $3,630.78 |
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 $724.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,288.25 | $1,288.25 |
Where Illinois sits
The same service costs 6.3 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· 23rd of 51
$2,399
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.