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 $776.25 Median $2,137.96 Typical High $7,762.47 | Facility | None | $776.25 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,122.02 | Professional | None | $776.25 | $776.25 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $12,022.64 Typical High $23,988.33 | Facility | None | $5,623.41 | $12,022.64 | $23,988.33 |
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 $776.25 Median $891.25 Typical High $1,412.54 | Professional | None | $776.25 | $891.25 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $3,801.89 | Professional | None | $776.25 | $1,202.26 | $3,801.89 |
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 $912.01 Median $954.99 Typical High $1,047.13 | Professional | None | $912.01 | $954.99 | $1,047.13 |
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 $2,238.72 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,238.72 | $5,888.44 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $776.25 | $1,071.52 | $1,698.24 |
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 $389.05 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $616.60 |
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· 28th of 51
$1,047
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.