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 $2,137.96 Typical High $7,762.47 | Facility | None | $724.44 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,513.56 | Professional | None | $645.65 | $724.44 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $10,000.00 | Facility | None | $2,454.71 | $3,890.45 | $10,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,380.38 | Professional | None | $741.31 | $1,288.25 | $1,380.38 |
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 $645.65 Median $812.83 Typical High $1,202.26 | Professional | None | $645.65 | $812.83 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $2,398.83 | Professional | None | $575.44 | $933.25 | $2,398.83 |
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 $645.65 Median $758.58 Typical High $851.14 | Professional | None | $645.65 | $758.58 | $851.14 |
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 $645.65 Median $954.99 Typical High $1,380.38 | Professional | None | $645.65 | $954.99 | $1,380.38 |
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 $323.59 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 5.9 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· 21st of 51
$1,122
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.