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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | None | $977.24 | $1,202.26 | $1,202.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $30,199.52 | Facility | None | $7,079.46 | $15,135.61 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,949.84 | $2,187.76 |
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 $891.25 Median $1,513.56 Typical High $2,089.30 | Professional | None | $891.25 | $1,513.56 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,071.52 | $1,819.70 | $3,890.45 |
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 $1,230.27 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,445.44 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,584.89 | Professional | None | $33.11 | $33.11 | $1,584.89 |
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 $831.76 Median $1,148.15 Typical High $2,238.72 | Professional | None | $831.76 | $1,148.15 | $2,238.72 |
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 $467.74 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $707.95 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $660.69 | $831.76 | $831.76 |
Where Illinois sits
The same service costs 21.9 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· 32nd of 51
$1,202
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.