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 $239.88 Median $1,348.96 Typical High $5,623.41 | Facility | None | $239.88 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | None | $169.82 | $208.93 | $302.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $4,897.79 | Facility | None | $2,238.72 | $3,388.44 | $4,897.79 |
BCBS Illinois Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
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 $204.17 Median $239.88 Typical High $398.11 | Professional | None | $204.17 | $239.88 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $707.95 | Professional | None | $208.93 | $331.13 | $707.95 |
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 $218.78 Median $234.42 Typical High $331.13 | Professional | None | $218.78 | $234.42 | $331.13 |
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 $186.21 Median $251.19 Typical High $467.74 | Professional | None | $186.21 | $251.19 | $467.74 |
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 $87.10 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $87.10 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $34.67 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $128.82 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $169.82 |
Where Illinois sits
The same service costs 4.4 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· 28th of 51
$288
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.