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 $263.03 Median $1,698.24 Typical High $5,623.41 | Facility | None | $263.03 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $407.38 | Professional | None | $151.36 | $239.88 | $407.38 |
BCBS Illinois Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $3,548.13 | Facility | None | $263.03 | $426.58 | $3,548.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $407.38 | Professional | None | $154.88 | $251.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Facility | None | $245.47 | $354.81 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $457.09 | Professional | None | $141.25 | $257.04 | $457.09 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $691.83 | Professional | None | $154.88 | $295.12 | $691.83 |
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 $177.83 Median $181.97 Typical High $302.00 | Professional | None | $177.83 | $181.97 | $302.00 |
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 $151.36 Median $239.88 Typical High $478.63 | Professional | None | $151.36 | $239.88 | $478.63 |
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 $74.13 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $74.13 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.79 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $158.49 | $181.97 |
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· 22nd of 51
$263
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.