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 $933.25 Median $2,818.38 Typical High $7,762.47 | Facility | None | $933.25 | $2,818.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,818.38 | $2,818.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $16,595.87 Median $35,481.34 Typical High $72,443.60 | Facility | None | $16,595.87 | $35,481.34 | $72,443.60 |
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 $2,238.72 Median $3,630.78 Typical High $5,248.07 | Professional | None | $2,238.72 | $3,630.78 | $5,248.07 |
Hally Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $7,413.10 | Professional | None | $2,570.40 | $4,168.69 | $7,413.10 |
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 $2,818.38 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,818.38 | $3,388.44 | $3,981.07 |
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 $2,344.23 Median $3,311.31 Typical High $6,025.60 | Professional | None | $2,344.23 | $3,311.31 | $6,025.60 |
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 $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,148.15 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $229.09 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,949.84 | $1,949.84 |
Where Illinois sits
The same service costs 17.4 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
$3,020
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.