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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,348.96 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $15,488.17 | Facility | None | $4,570.88 | $7,079.46 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,258.93 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $4,897.79 | Professional | None | $1,148.15 | $1,819.70 | $4,897.79 |
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 $1,380.38 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,445.44 | $1,584.89 |
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 $1,096.48 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,412.54 | $2,570.40 |
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 $524.81 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $933.25 | $933.25 |
Where Illinois sits
The same service costs 6.9 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· 28th of 51
$1,585
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.