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 $169.82 Median $223.87 Typical High $257.04 | Professional | None | $169.82 | $223.87 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $4,786.30 | Facility | None | $234.42 | $380.19 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $354.81 | Professional | None | $177.83 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $812.83 | Facility | None | $218.78 | $309.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $371.54 | Professional | None | $147.91 | $229.09 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $691.83 | Professional | None | $190.55 | $302.00 | $691.83 |
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 $199.53 Median $208.93 Typical High $316.23 | Professional | None | $199.53 | $208.93 | $316.23 |
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 $173.78 Median $245.47 Typical High $416.87 | Professional | None | $173.78 | $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 $85.11 Median $109.65 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $151.36 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $151.36 | $165.96 |
Where Illinois sits
The same service costs 3.8 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
$234
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.