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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $812.83 | Professional | None | $478.63 | $549.54 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $7,244.36 | Facility | None | $2,454.71 | $3,548.13 | $7,244.36 |
BCBS Illinois Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,122.02 | Professional | None | $691.83 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $3,630.78 | Facility | None | $741.31 | $2,818.38 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,949.84 | Professional | None | $524.81 | $812.83 | $1,949.84 |
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 $602.56 Median $676.08 Typical High $758.58 | Professional | None | $602.56 | $676.08 | $758.58 |
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 $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,148.15 | Professional | None | $467.74 | $630.96 | $1,148.15 |
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 $239.88 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $380.19 |
Where Illinois sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$871
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.