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 $181.97 Median $1,348.96 Typical High $5,623.41 | Facility | None | $181.97 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | None | $144.54 | $165.96 | $181.97 |
BCBS Illinois Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,691.53 | Facility | None | $977.24 | $1,479.11 | $2,691.53 |
BCBS Illinois Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $363.08 | Professional | None | $177.83 | $251.19 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,202.26 Typical High $1,513.56 | Facility | None | $478.63 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $323.59 | Professional | None | $173.78 | $218.78 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $575.44 | Professional | None | $177.83 | $263.03 | $575.44 |
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 $190.55 Median $199.53 Typical High $251.19 | Professional | None | $190.55 | $199.53 | $251.19 |
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 $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $354.81 | Professional | None | $154.88 | $204.17 | $354.81 |
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 $72.44 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $28.84 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $138.04 | Professional | 54 · Surgery only | $107.15 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $27.54 | Professional | 55 · Aftercare only | $21.38 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $117.49 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $100.00 | $117.49 | $128.82 |
Where Illinois sits
The same service costs 4.6 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· 23rd of 51
$240
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.