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 $1,023.29 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,479.11 | $1,819.70 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,311.31 Median $4,897.79 Typical High $16,982.44 | Facility | None | $3,311.31 | $4,897.79 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,890.45 Typical High $5,011.87 | Facility | None | $1,023.29 | $3,890.45 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,513.56 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,677.35 | Professional | None | $1,202.26 | $1,862.09 | $4,677.35 |
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 $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,584.89 | $1,737.80 |
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 $1,174.90 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,174.90 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,513.56 | $2,754.23 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,047.13 |
Where Illinois sits
The same service costs 7.1 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
$1,622
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.