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 $831.76 Median $2,238.72 Typical High $7,762.47 | Facility | None | $831.76 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,584.89 | $2,137.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,168.69 Median $6,606.93 Typical High $20,417.38 | Facility | None | $4,168.69 | $6,606.93 | $20,417.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,454.71 | Professional | None | $1,698.24 | $2,398.83 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,786.30 Typical High $6,165.95 | Facility | None | $741.31 | $4,786.30 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,659.59 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,495.41 | Professional | None | $1,445.44 | $2,238.72 | $5,495.41 |
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 $1,659.59 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,778.28 | $1,949.84 |
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 $12,589.25 | Facility | None | $1,288.25 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,905.46 | $3,162.28 |
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 $707.95 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,122.02 |
Where Illinois sits
The same service costs 5.8 times more in Alaska 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
$2,042
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.