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 $831.76 Median $2,187.76 Typical High $7,762.47 | Facility | None | $831.76 | $2,187.76 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,174.90 | $1,445.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,265.80 Typical High $13,489.63 | Facility | None | $2,630.27 | $4,265.80 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,584.89 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $3,890.45 | Facility | None | $741.31 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $891.25 | $1,174.90 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,981.07 | Professional | None | $954.99 | $1,479.11 | $3,981.07 |
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 $1,258.93 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,288.25 | $1,380.38 |
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 $912.01 Median $1,202.26 Typical High $2,187.76 | Professional | None | $912.01 | $1,202.26 | $2,187.76 |
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 $524.81 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $831.76 |
Where Illinois sits
The same service costs 7.2 times more in Alaska 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· 28th of 51
$1,349
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.