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 $912.01 Median $3,235.94 Typical High $9,332.54 | Facility | None | $912.01 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,258.93 | Professional | None | $794.33 | $912.01 | $1,258.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $12,022.64 Typical High $23,988.33 | Facility | None | $5,623.41 | $12,022.64 | $23,988.33 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,445.44 | $1,621.81 |
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 $954.99 Median $1,047.13 Typical High $1,698.24 | Professional | None | $954.99 | $1,047.13 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $5,495.41 | Professional | None | $912.01 | $1,412.54 | $5,495.41 |
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 $1,071.52 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,148.15 | $1,288.25 |
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 $7,762.47 | Facility | None | $1,174.90 | $3,090.30 | $7,762.47 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $933.25 | $1,202.26 | $1,995.26 |
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 $398.11 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $676.08 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $630.96 | $660.69 |
Where Illinois sits
The same service costs 6.3 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· 25th of 51
$1,288
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.