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 $354.81 Median $1,905.46 Typical High $6,025.60 | Facility | None | $354.81 | $1,905.46 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $354.81 | Professional | None | $204.17 | $309.03 | $354.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $4,073.80 | Facility | None | $371.54 | $602.56 | $4,073.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $549.54 | Professional | None | $213.80 | $338.84 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Facility | None | $346.74 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $616.60 | Professional | None | $199.53 | $338.84 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $977.24 | Professional | None | $213.80 | $389.05 | $977.24 |
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 $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
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 $229.09 Median $354.81 Typical High $630.96 | Professional | None | $229.09 | $354.81 | $630.96 |
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 $97.72 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $97.72 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $39.81 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $138.04 | $208.93 | $245.47 |
Where Illinois sits
The same service costs 4.3 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· 23rd of 51
$355
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.