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 $457.09 Median $1,548.82 Typical High $5,623.41 | Facility | None | $457.09 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | None | $436.52 | $457.09 | $457.09 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $5,888.44 | Facility | None | $2,238.72 | $3,311.31 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,570.40 Typical High $3,311.31 | Facility | None | $478.63 | $2,570.40 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $758.58 | Professional | None | $371.54 | $467.74 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,949.84 | Professional | None | $426.58 | $645.65 | $1,949.84 |
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 $549.54 Median $549.54 Typical High $602.56 | Professional | None | $549.54 | $549.54 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $57.54 | Professional | None | $33.11 | $33.11 | $57.54 |
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 $416.87 Median $478.63 Typical High $831.76 | Professional | None | $416.87 | $478.63 | $831.76 |
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 $213.80 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $323.59 |
Where Illinois sits
The same service costs 6.2 times more in Alaska 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· 38th of 51
$468
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.