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 $724.44 Median $3,235.94 Typical High $8,912.51 | Facility | None | $724.44 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $1,023.29 | Professional | None | $549.54 | $602.56 | $1,023.29 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,071.52 | Professional | None | $660.69 | $933.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $7,244.36 | Facility | None | $891.25 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,122.02 | Professional | None | $616.60 | $741.31 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $3,311.31 | Professional | None | $602.56 | $954.99 | $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 $707.95 Median $758.58 Typical High $831.76 | Professional | None | $707.95 | $758.58 | $831.76 |
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 $1,479.11 Median $5,011.87 Typical High $14,454.40 | Facility | None | $1,479.11 | $5,011.87 | $14,454.40 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,258.93 | Professional | None | $588.84 | $758.58 | $1,258.93 |
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 $275.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $416.87 |
Where Illinois sits
The same service costs 8.1 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· 24th of 51
$933
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.