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 $346.74 Median $1,318.26 Typical High $5,623.41 | Facility | None | $346.74 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $363.08 | Professional | None | $229.09 | $323.59 | $363.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $2,884.03 | Facility | None | $398.11 | $630.96 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $524.81 | Professional | None | $245.47 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $524.81 Typical High $851.14 | Facility | None | $371.54 | $524.81 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $562.34 | Professional | None | $245.47 | $295.12 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $660.69 | Professional | None | $269.15 | $446.68 | $660.69 |
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 $263.03 Median $281.84 Typical High $478.63 | Professional | None | $263.03 | $281.84 | $478.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | None | $33.11 | $33.11 | $37.15 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $630.96 | Professional | None | $223.87 | $331.13 | $630.96 |
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 $114.82 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $114.82 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $229.09 | $251.19 |
Where Illinois sits
The same service costs 3.6 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· 36th of 51
$324
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.