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 $251.19 Median $1,737.80 Typical High $5,623.41 | Facility | None | $251.19 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | None | $177.83 | $213.80 | $251.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $741.31 Median $1,096.48 Typical High $2,398.83 | Facility | None | $741.31 | $1,096.48 | $2,398.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $436.52 | Professional | None | $239.88 | $338.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,174.90 | Facility | None | $588.84 | $891.25 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $446.68 | Professional | None | $181.97 | $316.23 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $891.25 | Professional | None | $229.09 | $354.81 | $891.25 |
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 $229.09 Median $245.47 Typical High $354.81 | Professional | None | $229.09 | $245.47 | $354.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,071.52 Typical High $3,090.30 | Facility | None | $446.68 | $1,071.52 | $3,090.30 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $436.52 | Professional | None | $186.21 | $245.47 | $436.52 |
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 $87.10 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $87.10 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $35.48 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $131.83 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $177.83 |
Where Illinois sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 22nd of 51
$302
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.