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 $2,630.27 Typical High $7,762.47 | Facility | None | $933.25 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,630.27 | $3,311.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,481.54 Median $25,118.86 Typical High $50,118.72 | Facility | None | $11,481.54 | $25,118.86 | $50,118.72 |
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 $2,344.23 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,344.23 | $3,019.95 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $7,585.78 | Professional | None | $2,089.30 | $3,388.44 | $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 $2,344.23 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,344.23 | $2,691.53 | $3,019.95 |
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 $2,344.23 Median $3,235.94 Typical High $5,011.87 | Professional | None | $2,344.23 | $3,235.94 | $5,011.87 |
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $1,819.70 |
Where Illinois sits
The same service costs 5.4 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· 29th of 51
$2,818
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.