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 $120.23 Median $1,202.26 Typical High $7,762.47 | Facility | None | $120.23 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $177.83 | Professional | None | $104.71 | $138.04 | $177.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $2,630.27 | Facility | None | $524.81 | $630.96 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $269.15 | Professional | None | $123.03 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $234.42 | Professional | None | $74.13 | $162.18 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $309.03 | Professional | None | $120.23 | $194.98 | $309.03 |
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 $128.82 Median $131.83 Typical High $194.98 | Professional | None | $128.82 | $131.83 | $194.98 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $269.15 | Professional | None | $109.65 | $158.49 | $269.15 |
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 $54.95 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $75.86 | $97.72 | $112.20 |
Where Illinois sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 23rd of 51
$170
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.