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 $794.33 Median $1,905.46 Typical High $5,888.44 | Facility | None | $794.33 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,174.90 | Professional | None | $794.33 | $794.33 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $13,489.63 Median $28,840.32 Typical High $38,018.94 | Facility | None | $13,489.63 | $28,840.32 | $38,018.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $30,902.95 Typical High $39,810.72 | Facility | None | $630.96 | $30,902.95 | $39,810.72 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,479.11 | Professional | None | $812.83 | $912.01 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $3,467.37 | Professional | None | $794.33 | $1,258.93 | $3,467.37 |
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 $933.25 Median $1,000.00 Typical High $1,096.48 | Professional | None | $933.25 | $1,000.00 | $1,096.48 |
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 $1,659.59 Median $7,943.28 Typical High $26,302.68 | Facility | None | $1,659.59 | $7,943.28 | $26,302.68 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,778.28 | Professional | None | $812.83 | $1,096.48 | $1,778.28 |
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 $398.11 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $630.96 |
Where Illinois sits
The same service costs 6.8 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· 25th of 51
$1,175
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.