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 $1,071.52 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,202.26 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $11,220.18 | Facility | None | $2,454.71 | $3,890.45 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,445.44 | $1,584.89 |
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 $1,071.52 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,348.96 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,630.78 | Professional | None | $954.99 | $1,513.56 | $3,630.78 |
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 $1,047.13 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,258.93 | $1,412.54 |
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 $1,071.52 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,548.82 | $2,290.87 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $831.76 |
Where Illinois sits
The same service costs 4.6 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· 20th of 51
$1,622
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.