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 $363.08 Median $1,737.80 Typical High $5,623.41 | Facility | None | $363.08 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $363.08 | Professional | None | $269.15 | $338.84 | $363.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $5,128.61 | Facility | None | $2,187.76 | $3,019.95 | $5,128.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $501.19 | Professional | None | $288.40 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,630.27 Typical High $3,311.31 | Facility | None | $630.96 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $588.84 | Professional | None | $275.42 | $323.59 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $1,047.13 | Professional | None | $302.00 | $467.74 | $1,047.13 |
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 $316.23 Median $323.59 Typical High $478.63 | Professional | None | $316.23 | $323.59 | $478.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $48.98 | Professional | None | $33.11 | $33.11 | $48.98 |
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 $281.84 Median $380.19 Typical High $645.65 | Professional | None | $281.84 | $380.19 | $645.65 |
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 $134.90 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $134.90 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $53.70 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $199.53 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.92 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $257.04 |
Where Illinois sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$363
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.