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 $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,698.24 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $19,498.45 | Facility | None | $4,570.88 | $7,244.36 | $19,498.45 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $776.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $6,309.57 | Professional | None | $1,479.11 | $2,398.83 | $6,309.57 |
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 $1,778.28 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,862.09 | $2,041.74 |
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 $1,513.56 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,995.26 | $3,311.31 |
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 $660.69 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 7.1 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
$2,089
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.