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 $234.42 Median $1,318.26 Typical High $5,623.41 | Facility | None | $234.42 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $234.42 | Professional | None | $144.54 | $213.80 | $234.42 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $4,786.30 | Facility | None | $251.19 | $407.38 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $407.38 | Professional | None | $177.83 | $251.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $338.84 Typical High $537.03 | Facility | None | $234.42 | $338.84 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $363.08 | Professional | None | $173.78 | $229.09 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $630.96 | Professional | None | $165.96 | $281.84 | $630.96 |
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 $169.82 Median $173.78 Typical High $295.12 | Professional | None | $169.82 | $173.78 | $295.12 |
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 $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 $151.36 Median $245.47 Typical High $416.87 | Professional | None | $151.36 | $245.47 | $416.87 |
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 $72.44 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $162.18 |
Where Illinois sits
The same service costs 3.5 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
$229
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.