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 $91.20 Median $1,318.26 Typical High $5,623.41 | Facility | None | $91.20 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $144.54 | Professional | None | $60.26 | $87.10 | $144.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $1,288.25 | Facility | None | $257.04 | $309.03 | $1,288.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $165.96 | Professional | None | $70.79 | $104.71 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $169.82 | Professional | None | $67.61 | $102.33 | $169.82 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $229.09 | Professional | None | $81.28 | $131.83 | $229.09 |
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 $85.11 Median $87.10 Typical High $131.83 | Professional | None | $85.11 | $87.10 | $131.83 |
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 $478.63 Typical High $1,819.70 | Facility | None | $141.25 | $478.63 | $1,819.70 |
United Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $173.78 | Professional | None | $66.07 | $104.71 | $173.78 |
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 $30.20 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $30.20 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $61.66 Typical High $69.18 | Professional | 54 · Surgery only | $44.67 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.30 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $57.54 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $41.69 | $57.54 | $64.57 |
Where Illinois sits
The same service costs 3.8 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· 25th of 51
$105
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.