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 $218.78 Median $1,348.96 Typical High $5,623.41 | Facility | None | $218.78 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $269.15 | Professional | None | $134.90 | $194.98 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,584.89 | $2,454.71 | $3,467.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $338.84 | Professional | None | $134.90 | $208.93 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $2,818.38 | Facility | None | $478.63 | $2,187.76 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $316.23 | Professional | None | $131.83 | $186.21 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $501.19 | Professional | None | $141.25 | $234.42 | $501.19 |
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 $158.49 Median $158.49 Typical High $257.04 | Professional | None | $158.49 | $158.49 | $257.04 |
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 $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $380.19 | Professional | None | $125.89 | $199.53 | $380.19 |
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 $64.57 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $64.57 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $26.30 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $97.72 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $131.83 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $91.20 | $131.83 | $151.36 |
Where Illinois sits
The same service costs 4.7 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· 26th of 51
$209
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.