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 $831.76 Median $2,238.72 Typical High $7,762.47 | Facility | None | $831.76 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,348.96 | $1,348.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $16,982.44 | Facility | None | $6,309.57 | $9,332.54 | $16,982.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,995.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $7,244.36 Typical High $9,332.54 | Facility | None | $741.31 | $7,244.36 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,584.89 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $4,466.84 | Professional | None | $1,445.44 | $2,137.96 | $4,466.84 |
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 $1,698.24 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,698.24 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,659.59 | Professional | None | $33.11 | $33.11 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,513.56 | $2,754.23 |
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 $575.44 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $933.25 |
Where Illinois sits
The same service costs 11.0 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· 33rd of 51
$1,622
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.