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 $9,772.37 | Facility | None | $1,023.29 | $3,235.94 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,905.46 | $2,041.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,715.19 Median $22,908.68 Typical High $45,708.82 | Facility | None | $10,715.19 | $22,908.68 | $45,708.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,691.53 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $12,022.64 | Facility | None | $512.86 | $776.25 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,570.40 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $6,918.31 | Professional | None | $2,041.74 | $3,162.28 | $6,918.31 |
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 $2,344.23 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,344.23 | $2,570.40 | $2,818.38 |
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 $1,288.25 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,288.25 | $3,801.89 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,630.27 | $4,466.84 |
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 $851.14 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,348.96 |
Where Illinois sits
The same service costs 8.5 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· 26th of 51
$2,630
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.