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 $323.59 Median $3,019.95 Typical High $9,772.37 | Facility | None | $323.59 | $3,019.95 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $741.31 | Professional | None | $281.84 | $323.59 | $741.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $3,467.37 | Facility | None | $275.42 | $436.52 | $3,467.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $537.03 | Professional | None | $281.84 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $380.19 Typical High $933.25 | Facility | None | $257.04 | $380.19 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $758.58 | Professional | None | $302.00 | $478.63 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $1,819.70 | Professional | None | $269.15 | $426.58 | $1,819.70 |
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 $331.13 Median $331.13 Typical High $389.05 | Professional | None | $331.13 | $331.13 | $389.05 |
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 $446.68 Median $1,071.52 Typical High $3,019.95 | Facility | None | $446.68 | $1,071.52 | $3,019.95 |
United Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $912.01 | Professional | None | $302.00 | $630.96 | $912.01 |
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 $134.90 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $229.09 |
Where Illinois sits
The same service costs 5.0 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· 28th of 51
$437
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.