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 $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,445.44 | $1,445.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $15,848.93 Typical High $32,359.37 | Facility | None | $7,413.10 | $15,848.93 | $32,359.37 |
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 $1,348.96 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,862.09 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $5,754.40 | Professional | None | $1,412.54 | $2,089.30 | $5,754.40 |
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 $1,548.82 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,778.28 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $190.55 | Professional | None | $33.11 | $33.11 | $190.55 |
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 $1,318.26 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,584.89 | $2,691.53 |
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 $660.69 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,023.29 |
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· 31st of 51
$1,549
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.