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 $426.58 Median $1,318.26 Typical High $5,623.41 | Facility | None | $426.58 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $724.44 | Professional | None | $251.19 | $426.58 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $3,162.28 | Facility | None | $263.03 | $398.11 | $3,162.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $741.31 | Professional | None | $257.04 | $467.74 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $512.86 | Facility | None | $194.98 | $331.13 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $851.14 | Professional | None | $281.84 | $457.09 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $281.84 Median $549.54 Typical High $1,202.26 | Professional | None | $281.84 | $549.54 | $1,202.26 |
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 $302.00 Median $309.03 Typical High $562.34 | Professional | None | $302.00 | $309.03 | $562.34 |
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 $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $870.96 | Professional | None | $263.03 | $446.68 | $870.96 |
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 $125.89 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $125.89 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $50.12 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $190.55 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $38.02 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $25.12 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $177.83 | $288.40 | $338.84 |
Where Illinois sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 20th of 51
$447
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.