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 $1,174.90 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,380.38 | $1,380.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $17,782.79 | Facility | None | $6,309.57 | $9,332.54 | $17,782.79 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,621.81 | $2,041.74 | $2,398.83 |
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 $1,412.54 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,659.59 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $6,456.54 | Professional | None | $1,479.11 | $2,238.72 | $6,456.54 |
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 $1,584.89 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,737.80 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,737.80 | Professional | None | $33.11 | $33.11 | $1,737.80 |
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 $1,288.25 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,288.25 | $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 $588.84 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $977.24 |
Where Illinois sits
The same service costs 7.2 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
$1,660
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.