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 $1,548.82 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,584.89 | $1,778.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,481.54 Median $25,118.86 Typical High $50,118.72 | Facility | None | $11,481.54 | $25,118.86 | $50,118.72 |
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 $1,412.54 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,819.70 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,479.11 | $2,344.23 | $5,495.41 |
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 $1,659.59 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,905.46 | $2,137.96 |
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 $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 $1,479.11 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,995.26 | $3,467.37 |
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 $776.25 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,174.90 |
Where Illinois sits
The same service costs 5.6 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· 30th of 51
$1,820
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.