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 $371.54 Median $1,258.93 Typical High $7,762.47 | Facility | None | $371.54 | $1,258.93 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $616.60 | Professional | None | $363.08 | $457.09 | $616.60 |
BCBS Illinois Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $4,365.16 | Facility | None | $524.81 | $851.14 | $4,365.16 |
BCBS Illinois Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $891.25 | Professional | None | $426.58 | $616.60 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $645.65 Typical High $794.33 | Facility | None | $251.19 | $645.65 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $912.01 | Professional | None | $389.05 | $562.34 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,096.48 | Professional | None | $446.68 | $707.95 | $1,096.48 |
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 $501.19 Median $512.86 Typical High $707.95 | Professional | None | $501.19 | $512.86 | $707.95 |
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 $141.25 Median $501.19 Typical High $1,995.26 | Facility | None | $141.25 | $501.19 | $1,995.26 |
United Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $977.24 | Professional | None | $398.11 | $616.60 | $977.24 |
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 $173.78 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $309.03 | $338.84 |
Where Illinois sits
The same service costs 5.1 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· 20th of 51
$575
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.