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 $194.98 Median $1,348.96 Typical High $5,623.41 | Facility | None | $194.98 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $281.84 | Professional | None | $109.65 | $173.78 | $281.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,412.54 Median $2,344.23 Typical High $3,311.31 | Facility | None | $1,412.54 | $2,344.23 | $3,311.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $316.23 | Professional | None | $114.82 | $186.21 | $316.23 |
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 $109.65 Median $158.49 Typical High $275.42 | Professional | None | $109.65 | $158.49 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $416.87 | Professional | None | $117.49 | $204.17 | $416.87 |
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 $131.83 Median $134.90 Typical High $229.09 | Professional | None | $131.83 | $134.90 | $229.09 |
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 $109.65 Median $177.83 Typical High $331.13 | Professional | None | $109.65 | $177.83 | $331.13 |
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 $54.95 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $54.95 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $21.88 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $83.18 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $16.60 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.96 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $77.62 | $117.49 | $138.04 |
Where Illinois sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 32nd of 51
$182
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.