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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,120.11 Median $19,498.45 Typical High $38,904.51 | Facility | None | $9,120.11 | $19,498.45 | $38,904.51 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,548.82 Typical High $3,235.94 | Facility | None | $524.81 | $1,548.82 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,995.26 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,513.56 | $2,290.87 | $4,570.88 |
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 $1,548.82 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,862.09 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,137.96 | Professional | None | $33.11 | $33.11 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $16,595.87 | Facility | None | $1,659.59 | $7,413.10 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,584.89 | $2,884.03 |
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 $616.60 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,071.52 |
Where Illinois sits
The same service costs 5.9 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· 35th of 51
$1,585
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.