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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,659.59 | $1,659.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,912.51 Median $19,498.45 Typical High $38,904.51 | Facility | None | $8,912.51 | $19,498.45 | $38,904.51 |
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 $1,548.82 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,995.26 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $5,248.07 | Professional | None | $1,380.38 | $2,238.72 | $5,248.07 |
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 $1,548.82 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,819.70 | $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 $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 $1,412.54 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,905.46 | $3,235.94 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $1,148.15 | $1,148.15 |
Where Illinois sits
The same service costs 7.4 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· 27th of 51
$1,862
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.