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 $707.95 Median $1,862.09 Typical High $7,762.47 | Facility | None | $707.95 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | None | $645.65 | $707.95 | $707.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,630.78 Median $7,762.47 Typical High $15,848.93 | Facility | None | $3,630.78 | $7,762.47 | $15,848.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
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 $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $2,630.27 | Professional | None | $691.83 | $1,023.29 | $2,630.27 |
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 $776.25 Median $870.96 Typical High $977.24 | Professional | None | $776.25 | $870.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | None | $33.11 | $33.11 | $69.18 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,318.26 | Professional | None | $630.96 | $741.31 | $1,318.26 |
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 $323.59 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 5.4 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· 33rd of 51
$741
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.