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 $114.82 Median $1,202.26 Typical High $7,762.47 | Facility | None | $114.82 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $218.78 | Professional | None | $114.82 | $177.83 | $218.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,318.26 | $2,089.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $363.08 | Professional | None | $134.90 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $331.13 | Professional | None | $104.71 | $169.82 | $331.13 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $512.86 | Professional | None | $147.91 | $257.04 | $512.86 |
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 $141.25 Median $144.54 Typical High $263.03 | Professional | None | $141.25 | $144.54 | $263.03 |
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 $3,981.07 | Facility | None | $676.08 | $1,513.56 | $3,981.07 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $389.05 | Professional | None | $128.82 | $218.78 | $389.05 |
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 $56.23 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $56.23 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $131.83 |
Where Illinois sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 32nd of 51
$209
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.