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 $213.80 Median $1,737.80 Typical High $5,623.41 | Facility | None | $213.80 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $316.23 | Professional | None | $186.21 | $213.80 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,570.40 Median $3,388.44 Typical High $5,248.07 | Facility | None | $2,570.40 | $3,388.44 | $5,248.07 |
BCBS Illinois Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $501.19 | Professional | None | $223.87 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $3,890.45 | Facility | None | $645.65 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $371.54 | Professional | None | $213.80 | $281.84 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $707.95 | Professional | None | $204.17 | $316.23 | $707.95 |
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 $218.78 Median $234.42 Typical High $288.40 | Professional | None | $218.78 | $234.42 | $288.40 |
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 $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $457.09 | Professional | None | $194.98 | $281.84 | $457.09 |
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 $93.33 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $37.15 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $169.82 | Professional | 54 · Surgery only | $141.25 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $158.49 |
Where Illinois sits
The same service costs 5.9 times more in Oklahoma 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
$302
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.