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 $1,023.29 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,445.44 | $1,819.70 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $7,762.47 Typical High $16,595.87 | Facility | None | $6,309.57 | $7,762.47 | $16,595.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,949.84 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $5,248.07 | Professional | None | $1,230.27 | $1,995.26 | $5,248.07 |
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 $1,621.81 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,621.81 | $1,737.80 |
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 $1,318.26 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,466.84 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,548.82 | $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 $660.69 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,023.29 |
Where Illinois sits
The same service costs 8.3 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· 24th of 51
$1,862
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.