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 $562.34 Median $1,548.82 Typical High $5,623.41 | Facility | None | $562.34 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $812.83 | Professional | None | $489.78 | $562.34 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $19,054.61 | Facility | None | $2,630.27 | $4,168.69 | $19,054.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $891.25 | Professional | None | $575.44 | $870.96 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $3,019.95 Typical High $3,890.45 | Facility | None | $478.63 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $933.25 | Professional | None | $537.03 | $575.44 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $3,090.30 | Professional | None | $512.86 | $794.33 | $3,090.30 |
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 $588.84 Median $630.96 Typical High $691.83 | Professional | None | $588.84 | $630.96 | $691.83 |
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 $2,511.89 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,096.48 | Professional | None | $524.81 | $660.69 | $1,096.48 |
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 $245.47 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $398.11 |
Where Illinois sits
The same service costs 5.5 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
$794
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.