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 $707.95 Median $2,137.96 Typical High $7,762.47 | Facility | None | $707.95 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,000.00 | Professional | None | $616.60 | $707.95 | $1,000.00 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,365.16 Median $9,332.54 Typical High $18,620.87 | Facility | None | $4,365.16 | $9,332.54 | $18,620.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,258.93 | Professional | None | $851.14 | $1,122.02 | $1,258.93 |
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 $645.65 Median $831.76 Typical High $1,318.26 | Professional | None | $645.65 | $831.76 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $3,090.30 | Professional | None | $724.44 | $1,122.02 | $3,090.30 |
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 $831.76 Median $912.01 Typical High $1,000.00 | Professional | None | $831.76 | $912.01 | $1,000.00 |
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 $691.83 Median $912.01 Typical High $1,584.89 | Professional | None | $691.83 | $912.01 | $1,584.89 |
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 $309.03 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $537.03 |
Where Illinois sits
The same service costs 6.9 times more in Alaska 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· 30th of 51
$977
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.