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 $741.31 Median $2,089.30 Typical High $7,244.36 | Facility | None | $741.31 | $2,089.30 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Professional | None | $446.68 | $501.19 | $758.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $6,606.93 | Facility | None | $2,630.27 | $3,801.89 | $6,606.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $812.83 | Professional | None | $549.54 | $794.33 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,890.45 | Facility | None | $891.25 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $851.14 | Professional | None | $446.68 | $524.81 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,548.82 | Professional | None | $457.09 | $724.44 | $1,548.82 |
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 $537.03 Median $575.44 Typical High $616.60 | Professional | None | $537.03 | $575.44 | $616.60 |
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 $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,000.00 | Professional | None | $446.68 | $588.84 | $1,000.00 |
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 $223.87 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $354.81 | $363.08 |
Where Illinois sits
The same service costs 8.7 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· 22nd of 51
$741
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.