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 $758.58 Median $2,630.27 Typical High $7,762.47 | Facility | None | $758.58 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $954.99 | Professional | None | $691.83 | $831.76 | $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 $707.95 Median $1,000.00 Typical High $1,202.26 | Professional | None | $707.95 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,412.54 | Professional | None | $758.58 | $891.25 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $3,388.44 | Professional | None | $758.58 | $1,148.15 | $3,388.44 |
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 $794.33 Median $851.14 Typical High $1,174.90 | Professional | None | $794.33 | $851.14 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $114.82 | Professional | None | $33.11 | $33.11 | $114.82 |
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 $891.25 Typical High $1,479.11 | Professional | None | $707.95 | $891.25 | $1,479.11 |
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 $346.74 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $616.60 |
Where Illinois sits
The same service costs 4.4 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· 33rd of 51
$871
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.