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 $275.42 Median $1,318.26 Typical High $5,623.41 | Facility | None | $275.42 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $426.58 | Professional | None | $218.78 | $245.47 | $426.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $2,818.38 | Facility | None | $208.93 | $331.13 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $467.74 | Professional | None | $239.88 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $275.42 Typical High $512.86 | Facility | None | $194.98 | $275.42 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $426.58 | Professional | None | $208.93 | $309.03 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $851.14 | Professional | None | $204.17 | $346.74 | $851.14 |
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 $257.04 Median $269.15 Typical High $331.13 | Professional | None | $257.04 | $269.15 | $331.13 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $537.03 | Professional | None | $223.87 | $281.84 | $537.03 |
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 $109.65 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $43.65 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $162.18 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $190.55 |
Where Illinois sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 19th of 51
$309
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.