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 $213.80 Median $1,288.25 Typical High $5,623.41 | Facility | None | $213.80 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $288.40 | Professional | None | $120.23 | $199.53 | $288.40 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $4,786.30 | Facility | None | $251.19 | $407.38 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $380.19 | Professional | None | $134.90 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $338.84 Typical High $812.83 | Facility | None | $234.42 | $338.84 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $346.74 | Professional | None | $112.20 | $169.82 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $549.54 | Professional | None | $154.88 | $275.42 | $549.54 |
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 $147.91 Median $151.36 Typical High $281.84 | Professional | None | $147.91 | $151.36 | $281.84 |
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 $131.83 Median $223.87 Typical High $407.38 | Professional | None | $131.83 | $223.87 | $407.38 |
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 $61.66 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $18.20 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.30 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $138.04 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $85.11 | $138.04 | $151.36 |
Where Illinois sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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· 34th of 51
$219
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.