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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $831.76 | Professional | None | $562.34 | $630.96 | $831.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $7,244.36 | Facility | None | $1,659.59 | $2,630.27 | $7,244.36 |
BCBS Illinois Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $912.01 | Professional | None | $588.84 | $851.14 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,995.26 Typical High $2,570.40 | Facility | None | $891.25 | $1,995.26 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $870.96 | Professional | None | $602.56 | $707.95 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $2,137.96 | Professional | None | $524.81 | $812.83 | $2,137.96 |
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 $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $758.58 |
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 $501.19 Median $660.69 Typical High $1,230.27 | Professional | None | $501.19 | $660.69 | $1,230.27 |
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 $281.84 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $446.68 |
Where Illinois sits
The same service costs 8.5 times more in Wyoming 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· 28th of 51
$759
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.