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 $630.96 Median $2,089.30 Typical High $6,165.95 | Facility | None | $630.96 | $2,089.30 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,258.93 Typical High $1,778.28 | Professional | None | $363.08 | $1,258.93 | $1,778.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $5,888.44 | Facility | None | $2,454.71 | $3,630.78 | $5,888.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $426.58 Median $1,230.27 Typical High $3,235.94 | Professional | None | $426.58 | $1,230.27 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,630.78 | Facility | None | $741.31 | $2,884.03 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $812.83 Typical High $2,454.71 | Professional | None | $380.19 | $812.83 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $1,819.70 Typical High $3,019.95 | Professional | None | $407.38 | $1,819.70 | $3,019.95 |
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 $380.19 Median $426.58 Typical High $1,819.70 | Professional | None | $380.19 | $426.58 | $1,819.70 |
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 $371.54 Median $1,202.26 Typical High $2,754.23 | Professional | None | $371.54 | $1,202.26 | $2,754.23 |
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 $181.97 Median $436.52 Typical High $851.14 | Professional | 52 · Reduced service | $181.97 | $436.52 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $173.78 Typical High $338.84 | Professional | 53 · Discontinued | $74.13 | $173.78 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $645.65 Typical High $1,288.25 | Professional | 54 · Surgery only | $275.42 | $645.65 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $131.83 Typical High $257.04 | Professional | 55 · Aftercare only | $54.95 | $131.83 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $87.10 Typical High $169.82 | Professional | 56 · Pre-op care only | $36.31 | $87.10 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $602.56 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $257.04 | $602.56 | $1,202.26 |
Where Illinois sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 15th of 51
$1,698
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.