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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $1,023.29 | Professional | None | $436.52 | $489.78 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $6,456.54 | Facility | None | $3,090.30 | $4,365.16 | $6,456.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $630.96 | Professional | None | $467.74 | $562.34 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $5,011.87 | Facility | None | $776.25 | $3,801.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $758.58 | Professional | None | $436.52 | $575.44 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,621.81 | Professional | None | $398.11 | $645.65 | $1,621.81 |
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 $457.09 Median $512.86 Typical High $575.44 | Professional | None | $457.09 | $512.86 | $575.44 |
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 $8,912.51 | Facility | None | $1,174.90 | $3,090.30 | $8,912.51 |
United Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $933.25 | Professional | None | $426.58 | $630.96 | $933.25 |
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 $218.78 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $346.74 |
Where Illinois sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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· 33rd of 51
$646
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.