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 $165.96 Median $1,698.24 Typical High $5,623.41 | Facility | None | $165.96 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $204.17 | Professional | None | $112.20 | $147.91 | $204.17 |
BCBS Illinois Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $4,677.35 | Facility | None | $138.04 | $223.87 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $316.23 | Professional | None | $138.04 | $204.17 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $181.97 Typical High $812.83 | Facility | None | $128.82 | $181.97 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $269.15 | Professional | None | $134.90 | $190.55 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $467.74 | Professional | None | $138.04 | $229.09 | $467.74 |
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 $131.83 Median $144.54 Typical High $223.87 | Professional | None | $131.83 | $144.54 | $223.87 |
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 $123.03 Median $173.78 Typical High $302.00 | Professional | None | $123.03 | $173.78 | $302.00 |
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 $52.48 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $20.89 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $15.49 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.47 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $72.44 | $100.00 | $114.82 |
Where Illinois sits
The same service costs 3.6 times more in Wisconsin 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· 22nd of 51
$195
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.