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 $912.01 Median $1,905.46 Typical High $7,762.47 | Facility | None | $912.01 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,258.93 | Professional | None | $912.01 | $1,096.48 | $1,258.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,606.93 Median $14,125.38 Typical High $28,183.83 | Facility | None | $6,606.93 | $14,125.38 | $28,183.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,659.59 | $1,819.70 | $3,090.30 |
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 $977.24 Median $1,445.44 Typical High $2,137.96 | Professional | None | $977.24 | $1,445.44 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $4,897.79 | Professional | None | $1,023.29 | $1,659.59 | $4,897.79 |
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 $1,122.02 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,348.96 | $1,548.82 |
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 $1,023.29 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,548.82 | $2,344.23 |
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 $446.68 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $776.25 |
Where Illinois sits
The same service costs 18.6 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· 23rd of 51
$1,349
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.