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 $1,023.29 Median $3,235.94 Typical High $8,128.31 | Facility | None | $1,023.29 | $3,235.94 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,290.87 | $2,570.40 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $30,199.52 | Facility | None | $1,698.24 | $2,630.27 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,365.16 | Professional | None | $3,019.95 | $3,548.13 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,041.74 Typical High $2,691.53 | Facility | None | $891.25 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,630.78 | $4,786.30 |
Hally Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,168.69 Typical High $10,000.00 | Professional | None | $2,691.53 | $4,168.69 | $10,000.00 |
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 $3,162.28 Median $3,388.44 Typical High $3,801.89 | Professional | None | $3,162.28 | $3,388.44 | $3,801.89 |
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 $2,344.23 Median $3,467.37 Typical High $5,888.44 | Professional | None | $2,344.23 | $3,467.37 | $5,888.44 |
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 $1,148.15 Median $1,288.25 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,148.15 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $512.86 Typical High $524.81 | Professional | 53 · Discontinued | $457.09 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,737.80 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $398.11 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $257.04 Typical High $263.03 | Professional | 56 · Pre-op care only | $229.09 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,778.28 | $1,862.09 |
Where Illinois sits
The same service costs 15.8 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
$3,090
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.