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 $794.33 Median $3,235.94 Typical High $9,332.54 | Facility | None | $794.33 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,096.48 | Professional | None | $691.83 | $794.33 | $1,096.48 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,897.79 Median $10,471.29 Typical High $20,892.96 | Facility | None | $4,897.79 | $10,471.29 | $20,892.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,412.54 | Professional | None | $954.99 | $1,258.93 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,479.11 | Professional | None | $758.58 | $933.25 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $3,019.95 | Professional | None | $812.83 | $1,258.93 | $3,019.95 |
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 $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $933.25 | $1,023.29 | $1,122.02 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,778.28 | Professional | None | $794.33 | $1,047.13 | $1,778.28 |
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 $346.74 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $602.56 |
Where Illinois sits
The same service costs 6.2 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· 31st of 51
$1,023
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.