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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,047.13 | Professional | None | $588.84 | $588.84 | $1,047.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $8,317.64 | Facility | None | $1,000.00 | $1,621.81 | $8,317.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,148.15 | Professional | None | $724.44 | $977.24 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,548.82 | Facility | None | $707.95 | $1,202.26 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,202.26 | Professional | None | $616.60 | $758.58 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $2,691.53 | Professional | None | $660.69 | $1,023.29 | $2,691.53 |
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 $794.33 Median $812.83 Typical High $912.01 | Professional | None | $794.33 | $812.83 | $912.01 |
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 $660.69 Median $851.14 Typical High $1,412.54 | Professional | None | $660.69 | $851.14 | $1,412.54 |
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 $288.40 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $457.09 |
Where Illinois sits
The same service costs 5.9 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· 29th of 51
$912
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.