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 $812.83 Median $1,949.84 Typical High $5,888.44 | Facility | None | $812.83 | $1,949.84 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,949.84 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $22,387.21 | Facility | None | $4,570.88 | $7,244.36 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,760.83 | Facility | None | $630.96 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,862.09 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $7,585.78 | Professional | None | $1,698.24 | $2,691.53 | $7,585.78 |
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 $2,041.74 Median $2,089.30 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,089.30 | $2,344.23 |
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 $1,659.59 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,187.76 | $3,801.89 |
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 $758.58 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $758.58 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,348.96 | $1,348.96 |
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· 26th of 51
$2,344
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.