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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $645.65 | Professional | None | $398.11 | $457.09 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $6,025.60 | Facility | None | $2,630.27 | $3,890.45 | $6,025.60 |
BCBS Illinois Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $812.83 | Professional | None | $549.54 | $724.44 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,090.30 Typical High $3,890.45 | Facility | None | $630.96 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $831.76 | Professional | None | $416.87 | $524.81 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,380.38 | Professional | None | $457.09 | $707.95 | $1,380.38 |
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 $630.96 | Professional | None | $537.03 | $575.44 | $630.96 |
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 $436.52 Median $575.44 Typical High $977.24 | Professional | None | $436.52 | $575.44 | $977.24 |
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 $199.53 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $316.23 |
Where Illinois sits
The same service costs 8.9 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· 25th 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.