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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,122.02 | Professional | None | $630.96 | $707.95 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $8,128.31 | Facility | None | $2,630.27 | $3,890.45 | $8,128.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,023.29 | Professional | None | $660.69 | $954.99 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,890.45 | Facility | None | $891.25 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $977.24 | Professional | None | $537.03 | $707.95 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $2,818.38 | Professional | None | $588.84 | $912.01 | $2,818.38 |
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 $776.25 Median $776.25 Typical High $851.14 | Professional | None | $776.25 | $776.25 | $851.14 |
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 $602.56 Median $758.58 Typical High $1,412.54 | Professional | None | $602.56 | $758.58 | $1,412.54 |
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 $316.23 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 8.5 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· 31st of 51
$851
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.