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 $977.24 Median $3,311.31 Typical High $9,332.54 | Facility | None | $977.24 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,348.96 | Professional | None | $977.24 | $1,096.48 | $1,348.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $12,589.25 | Facility | None | $1,905.46 | $2,884.03 | $12,589.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,445.44 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $2,951.21 | Facility | None | $1,023.29 | $2,290.87 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,174.90 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,715.35 | Professional | None | $891.25 | $1,380.38 | $3,715.35 |
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 $1,174.90 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,202.26 | $1,288.25 |
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 $891.25 Median $1,148.15 Typical High $2,137.96 | Professional | None | $891.25 | $1,148.15 | $2,137.96 |
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 $489.78 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $758.58 |
Where Illinois sits
The same service costs 7.2 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· 25th of 51
$1,259
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.