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 $426.58 Median $1,445.44 Typical High $5,623.41 | Facility | None | $426.58 | $1,445.44 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | None | $398.11 | $426.58 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $4,570.88 | Facility | None | $194.98 | $295.12 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $426.58 | Facility | None | $134.90 | $245.47 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $676.08 | Professional | None | $416.87 | $446.68 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $1,479.11 | Professional | None | $416.87 | $616.60 | $1,479.11 |
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 $489.78 Median $512.86 Typical High $562.34 | Professional | None | $489.78 | $512.86 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | None | $33.11 | $33.11 | $51.29 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $776.25 | Professional | None | $398.11 | $467.74 | $776.25 |
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 $199.53 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $295.12 |
Where Illinois sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 34th of 51
$447
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.