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 $2,137.96 Typical High $7,762.47 | Facility | None | $812.83 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,288.25 | Professional | None | $794.33 | $912.01 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $12,022.64 | Facility | None | $2,630.27 | $4,168.69 | $12,022.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,344.23 | Professional | None | $870.96 | $1,230.27 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $3,890.45 | Facility | None | $741.31 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,513.56 | Professional | None | $891.25 | $1,000.00 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $2,630.27 | Professional | None | $831.76 | $1,318.26 | $2,630.27 |
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 $977.24 Median $1,023.29 Typical High $1,122.02 | Professional | None | $977.24 | $1,023.29 | $1,122.02 |
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 $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
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 $407.38 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $660.69 |
Where Illinois sits
The same service costs 6.6 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· 27th of 51
$1,202
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.