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 $295.12 Median $1,348.96 Typical High $5,623.41 | Facility | None | $295.12 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $398.11 | Professional | None | $204.17 | $281.84 | $398.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,187.76 | Facility | None | $446.68 | $676.08 | $2,187.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $549.54 | Professional | None | $229.09 | $354.81 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $549.54 Typical High $794.33 | Facility | None | $407.38 | $549.54 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $512.86 | Professional | None | $239.88 | $309.03 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $933.25 | Professional | None | $245.47 | $398.11 | $933.25 |
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 $398.11 | Professional | None | $245.47 | $251.19 | $398.11 |
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 $245.47 Median $389.05 Typical High $707.95 | Professional | None | $245.47 | $389.05 | $707.95 |
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 $102.33 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $213.80 |
Where Illinois sits
The same service costs 3.7 times more in Wisconsin 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· 31st of 51
$355
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.