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 $933.25 Median $3,235.94 Typical High $7,762.47 | Facility | None | $933.25 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,548.82 | Professional | None | $851.14 | $954.99 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $11,220.18 | Facility | None | $2,951.21 | $4,466.84 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,467.37 Typical High $4,365.16 | Facility | None | $891.25 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,348.96 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,548.82 | $3,311.31 |
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 $1,202.26 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,288.25 | $1,412.54 |
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 $1,174.90 Median $3,090.30 Typical High $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,187.76 | Professional | None | $912.01 | $1,258.93 | $2,187.76 |
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 $426.58 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $691.83 |
Where Illinois sits
The same service costs 8.3 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· 19th of 51
$1,445
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.