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 $204.17 Median $467.74 Typical High $5,128.61 | Facility | None | $204.17 | $467.74 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $371.54 | Professional | None | $158.49 | $218.78 | $371.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,122.02 | $1,659.59 | $2,818.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $426.58 | Professional | None | $204.17 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $1,737.80 | Facility | None | $630.96 | $1,348.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $416.87 | Professional | None | $177.83 | $263.03 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $549.54 | Professional | None | $204.17 | $323.59 | $549.54 |
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 $218.78 Median $229.09 Typical High $323.59 | Professional | None | $218.78 | $229.09 | $323.59 |
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 $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
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 $75.86 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $112.20 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $138.04 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $104.71 | $138.04 | $151.36 |
Where Illinois sits
The same service costs 4.7 times more in Alaska 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· 21st of 51
$288
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.