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 $1,122.02 Median $3,890.45 Typical High $14,125.38 | Facility | None | $1,122.02 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,148.15 | $2,041.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $15,848.93 | Facility | None | $4,570.88 | $7,079.46 | $15,848.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,412.54 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,412.54 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,995.26 | $4,786.30 |
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 $1,513.56 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,584.89 | $1,737.80 |
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 $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,621.81 | $2,691.53 |
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 $562.34 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $891.25 |
Where Illinois sits
The same service costs 6.2 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· 26th of 51
$1,778
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.