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 $933.25 Median $2,089.30 Typical High $6,165.95 | Facility | None | $933.25 | $2,089.30 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,621.81 | Professional | None | $954.99 | $1,071.52 | $1,621.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $14,125.38 | Facility | None | $2,630.27 | $4,168.69 | $14,125.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,659.59 | $1,698.24 |
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 $1,047.13 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,174.90 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $4,073.80 | Professional | None | $977.24 | $1,548.82 | $4,073.80 |
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 $1,148.15 Median $1,230.27 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,230.27 | $1,318.26 |
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 $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,288.25 | $2,137.96 |
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 $478.63 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $776.25 |
Where Illinois sits
The same service costs 5.9 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· 25th of 51
$1,445
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.