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 $616.60 Median $1,548.82 Typical High $5,623.41 | Facility | None | $616.60 | $1,548.82 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $776.25 | Professional | None | $549.54 | $616.60 | $776.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $7,079.46 | Facility | None | $1,905.46 | $2,884.03 | $7,079.46 |
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 $489.78 Median $630.96 Typical High $851.14 | Professional | None | $489.78 | $630.96 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $2,344.23 | Professional | None | $501.19 | $776.25 | $2,344.23 |
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 $660.69 Median $660.69 Typical High $724.44 | Professional | None | $660.69 | $660.69 | $724.44 |
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 $478.63 Median $616.60 Typical High $1,174.90 | Professional | None | $478.63 | $616.60 | $1,174.90 |
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 $275.42 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $426.58 | $426.58 |
Where Illinois sits
The same service costs 8.3 times more in Wyoming than in Texas. 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
$708
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.