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 $107.15 Median $1,202.26 Typical High $7,762.47 | Facility | None | $107.15 | $1,202.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $165.96 | Professional | None | $93.33 | $128.82 | $165.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $2,951.21 | Facility | None | $151.36 | $158.49 | $2,951.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $257.04 | Professional | None | $112.20 | $165.96 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $812.83 | Facility | None | $134.90 | $190.55 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $275.42 | Professional | None | $107.15 | $154.88 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $354.81 | Professional | None | $117.49 | $194.98 | $354.81 |
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 $117.49 Median $120.23 Typical High $186.21 | Professional | None | $117.49 | $120.23 | $186.21 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $263.03 | Professional | None | $97.72 | $144.54 | $263.03 |
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 $48.98 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $48.98 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $19.50 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $100.00 Typical High $114.82 | Professional | 54 · Surgery only | $72.44 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.77 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $93.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $67.61 | $93.33 | $107.15 |
Where Illinois sits
The same service costs 3.5 times more in Wisconsin 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· 24th of 51
$162
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.