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 $501.19 Median $1,737.80 Typical High $5,623.41 | Facility | None | $501.19 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $812.83 | Professional | None | $354.81 | $501.19 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,238.72 | $3,311.31 | $5,754.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $933.25 | Professional | None | $389.05 | $602.56 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,630.27 Typical High $3,311.31 | Facility | None | $630.96 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $851.14 | Professional | None | $416.87 | $512.86 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,230.27 | Professional | None | $426.58 | $691.83 | $1,230.27 |
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 $446.68 Median $457.09 Typical High $707.95 | Professional | None | $446.68 | $457.09 | $707.95 |
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 $676.08 Median $1,513.56 Typical High $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $954.99 | Professional | None | $380.19 | $588.84 | $954.99 |
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 $177.83 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $177.83 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $35.48 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $338.84 | $371.54 |
Where Illinois sits
The same service costs 4.4 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· 29th of 51
$603
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.