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 $426.58 Median $1,318.26 Typical High $5,623.41 | Facility | None | $426.58 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $537.03 | Professional | None | $338.84 | $426.58 | $537.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $4,466.84 | Facility | None | $446.68 | $724.44 | $4,466.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $776.25 | Professional | None | $354.81 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $870.96 | Facility | None | $416.87 | $588.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $707.95 | Professional | None | $245.47 | $446.68 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $933.25 | Professional | None | $323.59 | $562.34 | $933.25 |
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 $407.38 Median $416.87 Typical High $575.44 | Professional | None | $407.38 | $416.87 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $6,165.95 | Facility | None | $1,047.13 | $2,454.71 | $6,165.95 |
United Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $851.14 | Professional | None | $331.13 | $446.68 | $851.14 |
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 $169.82 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $169.82 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $67.61 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $363.08 | Professional | 54 · Surgery only | $251.19 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $338.84 |
Where Illinois sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$513
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.