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 $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,348.96 | Professional | None | $977.24 | $1,096.48 | $1,348.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $12,302.69 | Facility | None | $1,659.59 | $2,630.27 | $12,302.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,445.44 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,511.89 | Facility | None | $741.31 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,479.11 | Professional | None | $831.76 | $1,096.48 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,715.35 | Professional | None | $891.25 | $1,380.38 | $3,715.35 |
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 $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
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 $870.96 Median $1,096.48 Typical High $2,041.74 | Professional | None | $870.96 | $1,096.48 | $2,041.74 |
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 $489.78 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $758.58 |
Where Illinois sits
The same service costs 7.4 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· 24th of 51
$1,259
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.