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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,380.38 | $1,380.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $30,199.52 | Facility | None | $7,079.46 | $15,135.61 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,778.28 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $5,370.32 | Professional | None | $1,348.96 | $1,949.84 | $5,370.32 |
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 $1,445.44 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,659.59 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $181.97 | Professional | None | $33.11 | $33.11 | $181.97 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,513.56 | $2,570.40 |
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 $630.96 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $977.24 |
Where Illinois sits
The same service costs 26.3 times more in Alaska than in Texas. 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
$1,479
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.