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 $186.21 Median $1,698.24 Typical High $5,623.41 | Facility | None | $186.21 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $213.80 | Professional | None | $114.82 | $181.97 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $2,630.27 | Facility | None | $251.19 | $398.11 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $380.19 | Professional | None | $144.54 | $245.47 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $812.83 | Facility | None | $234.42 | $331.13 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $338.84 | Professional | None | $125.89 | $177.83 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $524.81 | Professional | None | $151.36 | $269.15 | $524.81 |
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 $154.88 Median $158.49 Typical High $275.42 | Professional | None | $154.88 | $158.49 | $275.42 |
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 $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $371.54 | Professional | None | $131.83 | $213.80 | $371.54 |
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 $57.54 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $38.90 | Professional | 53 · Discontinued | $22.91 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $144.54 | Professional | 54 · Surgery only | $87.10 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $17.38 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $125.89 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $81.28 | $125.89 | $134.90 |
Where Illinois sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 30th of 51
$224
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.