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 $380.19 Median $1,548.82 Typical High $5,623.41 | Facility | None | $380.19 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | None | $302.00 | $354.81 | $446.68 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,623.41 | Facility | None | $2,630.27 | $3,890.45 | $5,623.41 |
BCBS Illinois Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $616.60 | Professional | None | $416.87 | $549.54 | $616.60 |
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 $251.19 Median $389.05 Typical High $602.56 | Professional | None | $251.19 | $389.05 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $1,148.15 | Professional | None | $338.84 | $549.54 | $1,148.15 |
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 $416.87 Median $446.68 Typical High $489.78 | Professional | None | $416.87 | $446.68 | $489.78 |
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 $2,511.89 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $724.44 | Professional | None | $323.59 | $407.38 | $724.44 |
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 $151.36 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $245.47 |
Where Illinois sits
The same service costs 8.5 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· 21st of 51
$550
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.