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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $676.08 | Professional | None | $416.87 | $478.63 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $11,220.18 | Facility | None | $4,786.30 | $6,606.93 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $870.96 | Professional | None | $537.03 | $776.25 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $7,244.36 | Facility | None | $741.31 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $891.25 | Professional | None | $457.09 | $562.34 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,698.24 | Professional | None | $501.19 | $776.25 | $1,698.24 |
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 $616.60 Typical High $676.08 | Professional | None | $588.84 | $616.60 | $676.08 |
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 $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,047.13 | Professional | None | $478.63 | $602.56 | $1,047.13 |
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 $208.93 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $338.84 |
Where Illinois sits
The same service costs 11.2 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
$741
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.