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 $870.96 Median $870.96 Typical High $1,288.25 | Professional | None | $870.96 | $870.96 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,168.69 Median $6,456.54 Typical High $13,803.84 | Facility | None | $4,168.69 | $6,456.54 | $13,803.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $6,165.95 | Facility | None | $630.96 | $4,786.30 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,621.81 | Professional | None | $912.01 | $1,000.00 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,311.31 | Professional | None | $891.25 | $1,380.38 | $3,311.31 |
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 $1,023.29 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,096.48 | $1,202.26 |
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 $1,174.90 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,090.30 | $9,772.37 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,949.84 | Professional | None | $891.25 | $1,202.26 | $1,949.84 |
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 $436.52 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
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· 27th of 51
$1,288
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.