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 $1,047.13 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,174.90 | $1,479.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $10,964.78 | Facility | None | $2,454.71 | $3,890.45 | $10,964.78 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,884.03 Typical High $3,630.78 | Facility | None | $776.25 | $2,884.03 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,380.38 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $3,801.89 | Professional | None | $933.25 | $1,513.56 | $3,801.89 |
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 $1,023.29 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,230.27 | $1,380.38 |
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 $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,479.11 | $2,238.72 |
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 $524.81 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $870.96 |
Where Illinois sits
The same service costs 4.7 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
$1,585
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.