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 $186.21 Median $1,148.15 Typical High $5,623.41 | Facility | None | $186.21 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $257.04 | Professional | None | $138.04 | $218.78 | $257.04 |
BCBS Illinois Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $1,513.56 | Facility | None | $302.00 | $489.78 | $1,513.56 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $363.08 | Professional | None | $154.88 | $257.04 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $537.03 | Facility | None | $281.84 | $398.11 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $426.58 | Professional | None | $123.03 | $239.88 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $616.60 | Professional | None | $165.96 | $302.00 | $616.60 |
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 $165.96 Median $173.78 Typical High $323.59 | Professional | None | $165.96 | $173.78 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | None | $33.11 | $33.11 | $35.48 |
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 $141.25 Median $229.09 Typical High $416.87 | Professional | None | $141.25 | $229.09 | $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 $69.18 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $69.18 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $28.18 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $104.71 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $97.72 | $154.88 | $169.82 |
Where Illinois sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 27th of 51
$240
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.