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 $707.95 Median $1,995.26 Typical High $6,165.95 | Facility | None | $707.95 | $1,995.26 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $954.99 | Professional | None | $660.69 | $870.96 | $954.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,466.84 Median $6,760.83 Typical High $10,232.93 | Facility | None | $4,466.84 | $6,760.83 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,412.54 | Professional | None | $660.69 | $977.24 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $6,760.83 | Facility | None | $741.31 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,513.56 | Professional | None | $660.69 | $870.96 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,511.89 | Professional | None | $691.83 | $1,122.02 | $2,511.89 |
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 $724.44 Median $776.25 Typical High $1,122.02 | Professional | None | $724.44 | $776.25 | $1,122.02 |
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 $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,949.84 | Professional | None | $707.95 | $1,047.13 | $1,949.84 |
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 $331.13 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $602.56 | $660.69 |
Where Illinois sits
The same service costs 5.2 times more in Alaska 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
$1,000
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.