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 $288.40 Median $1,737.80 Typical High $5,623.41 | Facility | None | $288.40 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $380.19 | Professional | None | $194.98 | $275.42 | $380.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,137.96 | Facility | None | $446.68 | $676.08 | $2,137.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $549.54 | Professional | None | $223.87 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $794.33 | Facility | None | $416.87 | $575.44 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $501.19 | Professional | None | $186.21 | $275.42 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $776.25 | Professional | None | $223.87 | $389.05 | $776.25 |
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 $245.47 Median $251.19 Typical High $389.05 | Professional | None | $245.47 | $251.19 | $389.05 |
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 $141.25 Median $501.19 Typical High $1,862.09 | Facility | None | $141.25 | $501.19 | $1,862.09 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $616.60 | Professional | None | $229.09 | $354.81 | $616.60 |
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 $97.72 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $97.72 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $147.91 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $29.51 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $138.04 | $186.21 | $204.17 |
Where Illinois sits
The same service costs 3.7 times more in Wisconsin 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· 31st of 51
$339
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.