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 $645.65 Median $1,258.93 Typical High $7,762.47 | Facility | None | $645.65 | $1,258.93 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $912.01 | Professional | None | $660.69 | $741.31 | $912.01 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $12,882.50 | Facility | None | $4,786.30 | $7,244.36 | $12,882.50 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,754.40 Typical High $7,244.36 | Facility | None | $776.25 | $5,754.40 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,412.54 | Professional | None | $776.25 | $870.96 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $2,691.53 | Professional | None | $776.25 | $1,202.26 | $2,691.53 |
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 $912.01 Median $954.99 Typical High $1,047.13 | Professional | None | $912.01 | $954.99 | $1,047.13 |
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 $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,659.59 | Professional | None | $758.58 | $977.24 | $1,659.59 |
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 $331.13 Median $371.54 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $537.03 |
Where Illinois sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$1,072
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.