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 $275.42 Median $1,905.46 Typical High $6,165.95 | Facility | None | $275.42 | $1,905.46 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $416.87 | Professional | None | $204.17 | $251.19 | $416.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,698.24 | $2,454.71 | $3,630.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $524.81 | Professional | None | $251.19 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $2,570.40 | Facility | None | $741.31 | $2,041.74 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $446.68 | Professional | None | $204.17 | $275.42 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $758.58 | Professional | None | $229.09 | $380.19 | $758.58 |
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 $251.19 Median $269.15 Typical High $380.19 | Professional | None | $251.19 | $269.15 | $380.19 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $524.81 | Professional | None | $213.80 | $288.40 | $524.81 |
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 $100.00 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $100.00 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $39.81 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $147.91 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $138.04 | $165.96 | $190.55 |
Where Illinois sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 27th of 51
$331
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.