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 $218.78 Median $1,348.96 Typical High $5,623.41 | Facility | None | $218.78 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $218.78 | Professional | None | $158.49 | $199.53 | $218.78 |
BCBS Illinois Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,630.27 | Facility | None | $977.24 | $1,479.11 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $323.59 | Professional | None | $165.96 | $245.47 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,202.26 Typical High $1,513.56 | Facility | None | $478.63 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $338.84 | Professional | None | $173.78 | $213.80 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $562.34 | Professional | None | $177.83 | $275.42 | $562.34 |
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 $186.21 Median $194.98 Typical High $288.40 | Professional | None | $186.21 | $194.98 | $288.40 |
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 $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $380.19 | Professional | None | $162.18 | $223.87 | $380.19 |
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 $79.43 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $79.43 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $32.36 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $120.23 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $112.20 | $141.25 | $154.88 |
Where Illinois sits
The same service costs 4.2 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· 31st of 51
$219
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.