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 $812.83 Median $2,089.30 Typical High $7,762.47 | Facility | None | $812.83 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $7,244.36 | Facility | None | $2,630.27 | $3,890.45 | $7,244.36 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,122.02 | Professional | None | $758.58 | $891.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $5,495.41 | Facility | None | $1,778.28 | $3,235.94 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,148.15 | Professional | None | $616.60 | $831.76 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $3,162.28 | Professional | None | $645.65 | $933.25 | $3,162.28 |
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 $691.83 Median $794.33 Typical High $891.25 | Professional | None | $691.83 | $794.33 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $87.10 | Professional | None | $33.11 | $33.11 | $87.10 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,202.26 | Professional | None | $602.56 | $707.95 | $1,202.26 |
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 $295.12 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $457.09 |
Where Illinois sits
The same service costs 5.9 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
$692
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.