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 $1,122.02 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,258.93 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $12,022.64 | Facility | None | $4,786.30 | $7,079.46 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,623.41 Typical High $7,244.36 | Facility | None | $776.25 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,548.82 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,621.81 | $4,073.80 |
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 $1,122.02 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,318.26 | $1,479.11 |
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 $1,479.11 Median $5,011.87 Typical High $13,489.63 | Facility | None | $1,479.11 | $5,011.87 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,737.80 | $2,454.71 |
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 $562.34 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $933.25 |
Where Illinois sits
The same service costs 5.1 times more in Wisconsin 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· 22nd of 51
$1,778
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.