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 $758.58 Median $3,311.31 Typical High $9,332.54 | Facility | None | $758.58 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $7,244.36 | Facility | None | $2,630.27 | $3,890.45 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,023.29 | $3,162.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $831.76 | Professional | None | $524.81 | $676.08 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $2,238.72 | Professional | None | $457.09 | $741.31 | $2,238.72 |
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 $602.56 Median $616.60 Typical High $660.69 | Professional | None | $602.56 | $616.60 | $660.69 |
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 $467.74 Median $588.84 Typical High $1,096.48 | Professional | None | $467.74 | $588.84 | $1,096.48 |
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 $251.19 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $389.05 |
Where Illinois sits
The same service costs 7.9 times more in Wyoming 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· 27th 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.