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 $138.04 Median $1,318.26 Typical High $5,623.41 | Facility | None | $138.04 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $213.80 | Professional | None | $87.10 | $128.82 | $213.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $1,047.13 | Facility | None | $147.91 | $239.88 | $1,047.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $251.19 | Professional | None | $97.72 | $158.49 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $263.03 | Facility | None | $102.33 | $186.21 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $245.47 | Professional | None | $93.33 | $144.54 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $309.03 | Professional | None | $112.20 | $194.98 | $309.03 |
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 $114.82 Median $120.23 Typical High $199.53 | Professional | None | $114.82 | $120.23 | $199.53 |
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 $95.50 Median $158.49 Typical High $263.03 | Professional | None | $95.50 | $158.49 | $263.03 |
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 $40.74 Median $61.66 Typical High $69.18 | Professional | 52 · Reduced service | $40.74 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $27.54 | Professional | 53 · Discontinued | $16.22 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $93.33 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $20.42 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.30 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.13 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $56.23 | $87.10 | $95.50 |
Where Illinois sits
The same service costs 3.5 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· 23rd of 51
$155
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.