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 $3,548.13 Typical High $10,232.93 | Facility | None | $812.83 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $812.83 | Professional | None | $426.58 | $478.63 | $812.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $10,471.29 | Facility | None | $4,466.84 | $6,309.57 | $10,471.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $776.25 | Professional | None | $524.81 | $758.58 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $5,495.41 Typical High $6,760.83 | Facility | None | $1,862.09 | $5,495.41 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $794.33 | Professional | None | $416.87 | $501.19 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,479.11 | Professional | None | $436.52 | $676.08 | $1,479.11 |
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 $512.86 Median $537.03 Typical High $588.84 | Professional | None | $512.86 | $537.03 | $588.84 |
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 $1,479.11 Median $5,011.87 Typical High $14,454.40 | Facility | None | $1,479.11 | $5,011.87 | $14,454.40 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $954.99 | Professional | None | $426.58 | $549.54 | $954.99 |
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 $213.80 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $85.11 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $346.74 |
Where Illinois sits
The same service costs 9.5 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· 23rd of 51
$692
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.