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 $758.58 Median $1,905.46 Typical High $7,762.47 | Facility | None | $758.58 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,380.38 | Professional | None | $707.95 | $954.99 | $1,380.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $12,302.69 Typical High $24,547.09 | Facility | None | $5,754.40 | $12,302.69 | $24,547.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,412.54 | $1,513.56 |
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 $912.01 Median $1,122.02 Typical High $1,737.80 | Professional | None | $912.01 | $1,122.02 | $1,737.80 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,311.31 | Professional | None | $912.01 | $1,445.44 | $3,311.31 |
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 $1,000.00 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,174.90 | $1,348.96 |
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 $851.14 Median $1,202.26 Typical High $2,041.74 | Professional | None | $851.14 | $1,202.26 | $2,041.74 |
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 $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $524.81 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $660.69 | $707.95 |
Where Illinois sits
The same service costs 6.6 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· 25th of 51
$1,148
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.