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 $1,258.93 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,584.89 | $2,089.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $18,620.87 | Facility | None | $4,570.88 | $7,244.36 | $18,620.87 |
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 $1,479.11 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,862.09 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $5,754.40 | Professional | None | $1,412.54 | $2,187.76 | $5,754.40 |
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 $1,659.59 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,659.59 | $1,737.80 | $1,905.46 |
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 $1,174.90 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,090.30 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,905.46 | $3,162.28 |
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 $630.96 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $158.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,122.02 | $1,122.02 |
Where Illinois sits
The same service costs 6.5 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
$1,950
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.