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 $3,311.31 Typical High $7,762.47 | Facility | None | $933.25 | $3,311.31 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $4,168.69 | Professional | None | $2,951.21 | $3,311.31 | $4,168.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,791.08 Median $31,622.78 Typical High $63,095.73 | Facility | None | $14,791.08 | $31,622.78 | $63,095.73 |
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 $2,691.53 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,691.53 | $3,235.94 | $5,495.41 |
Hally Health Setting Professional Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $11,220.18 | Professional | None | $2,630.27 | $4,168.69 | $11,220.18 |
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 $2,951.21 Median $3,467.37 Typical High $3,890.45 | Professional | None | $2,951.21 | $3,467.37 | $3,890.45 |
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 $2,818.38 Median $4,073.80 Typical High $6,309.57 | Professional | None | $2,818.38 | $4,073.80 | $6,309.57 |
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 $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,479.11 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,238.72 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,344.23 | $2,344.23 |
Where Illinois sits
The same service costs 6.9 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· 30th of 51
$3,311
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.