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 $338.84 Median $1,905.46 Typical High $6,025.60 | Facility | None | $338.84 | $1,905.46 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $338.84 | Professional | None | $199.53 | $302.00 | $338.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $4,073.80 | Facility | None | $363.08 | $588.84 | $4,073.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $512.86 | Professional | None | $213.80 | $331.13 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $812.83 | Facility | None | $338.84 | $478.63 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $602.56 | Professional | None | $245.47 | $331.13 | $602.56 |
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 $223.87 Median $338.84 Typical High $616.60 | Professional | None | $223.87 | $338.84 | $616.60 |
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 $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $97.72 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $39.81 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $218.78 Typical High $257.04 | Professional | 54 · Surgery only | $147.91 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $29.51 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $138.04 | $204.17 | $239.88 |
Where Illinois sits
The same service costs 4.2 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· 26th of 51
$339
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.