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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,288.25 | Professional | None | $537.03 | $588.84 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,548.13 Median $4,570.88 Typical High $8,317.64 | Facility | None | $3,548.13 | $4,570.88 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,073.80 Typical High $5,248.07 | Facility | None | $891.25 | $4,073.80 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,000.00 | Professional | None | $524.81 | $660.69 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,778.28 | Professional | None | $489.78 | $758.58 | $1,778.28 |
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 $549.54 Median $616.60 Typical High $691.83 | Professional | None | $549.54 | $616.60 | $691.83 |
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 $512.86 Median $741.31 Typical High $1,122.02 | Professional | None | $512.86 | $741.31 | $1,122.02 |
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 $263.03 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $426.58 |
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· 27th of 51
$891
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.