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 $2,754.23 Typical High $7,762.47 | Facility | None | $933.25 | $2,754.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,754.23 | $3,019.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,791.08 Median $31,622.78 Typical High $63,095.73 | Facility | None | $14,791.08 | $31,622.78 | $63,095.73 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,691.53 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,715.35 Typical High $9,120.11 | Professional | None | $2,398.83 | $3,715.35 | $9,120.11 |
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 $2,818.38 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,818.38 | $2,951.21 | $3,311.31 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $5,495.41 | Professional | None | $2,398.83 | $3,019.95 | $5,495.41 |
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 $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,071.52 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $426.58 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,621.81 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $323.59 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,905.46 | $1,905.46 |
Where Illinois sits
The same service costs 11.0 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· 29th of 51
$2,754
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.