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 $831.76 Median $2,238.72 Typical High $7,762.47 | Facility | None | $831.76 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,202.26 | $1,479.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $13,803.84 | Facility | None | $1,905.46 | $2,884.03 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $2,818.38 | Facility | None | $741.31 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,258.93 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $4,073.80 | Professional | None | $977.24 | $1,513.56 | $4,073.80 |
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 $1,288.25 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,318.26 | $1,412.54 |
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 $1,288.25 Median $4,073.80 Typical High $10,000.00 | Facility | None | $1,288.25 | $4,073.80 | $10,000.00 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,344.23 | Professional | None | $977.24 | $1,258.93 | $2,344.23 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $851.14 |
Where Illinois sits
The same service costs 7.6 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· 29th of 51
$1,349
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.