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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $691.83 | Professional | None | $354.81 | $489.78 | $691.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,019.95 Median $6,456.54 Typical High $12,882.50 | Facility | None | $3,019.95 | $6,456.54 | $12,882.50 |
BCBS Illinois Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $831.76 | Professional | None | $575.44 | $776.25 | $831.76 |
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 $457.09 Median $562.34 Typical High $891.25 | Professional | None | $457.09 | $562.34 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,659.59 | Professional | None | $467.74 | $741.31 | $1,659.59 |
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 $524.81 Median $602.56 Typical High $676.08 | Professional | None | $524.81 | $602.56 | $676.08 |
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 $426.58 Median $602.56 Typical High $1,023.29 | Professional | None | $426.58 | $602.56 | $1,023.29 |
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 $177.83 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $53.70 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $251.19 | $338.84 | $354.81 |
Where Illinois sits
The same service costs 7.2 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· 19th of 51
$661
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.