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 $776.25 Median $1,621.81 Typical High $5,623.41 | Facility | None | $776.25 | $1,621.81 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,548.82 | Professional | None | $741.31 | $912.01 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,698.24 | Professional | None | $676.08 | $676.08 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $9,120.11 | Facility | None | $1,698.24 | $2,630.27 | $9,120.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $891.25 | $1,202.26 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $2,570.40 | Facility | None | $630.96 | $1,995.26 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,698.24 | Professional | None | $794.33 | $1,122.02 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,398.83 | Professional | None | $912.01 | $1,412.54 | $2,398.83 |
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 $1,023.29 Median $1,047.13 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,047.13 | $1,348.96 |
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 $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,905.46 | Professional | None | $812.83 | $1,174.90 | $1,905.46 |
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 $354.81 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $645.65 |
Where Illinois sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 16th of 51
$1,202
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.