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 $1,905.46 Typical High $5,888.44 | Facility | None | $812.83 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $15,848.93 | Facility | None | $1,513.56 | $2,454.71 | $15,848.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $426.58 Median $1,819.70 Typical High $1,949.84 | Professional | None | $426.58 | $1,819.70 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,819.70 Typical High $2,398.83 | Facility | None | $776.25 | $1,819.70 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,202.26 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $4,466.84 | Professional | None | $1,023.29 | $1,584.89 | $4,466.84 |
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 $1,202.26 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,288.25 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,445.44 | $2,238.72 |
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 $512.86 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
Where Illinois sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 24th of 51
$1,445
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.