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 $794.33 Median $2,137.96 Typical High $7,762.47 | Facility | None | $794.33 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | None | $794.33 | $851.14 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $11,220.18 | Facility | None | $4,570.88 | $6,760.83 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,548.82 | Professional | None | $977.24 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $6,760.83 | Facility | None | $741.31 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,445.44 | Professional | None | $870.96 | $977.24 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,388.44 | Professional | None | $912.01 | $1,380.38 | $3,388.44 |
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 $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,071.52 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $933.25 | Professional | None | $33.11 | $91.20 | $933.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,698.24 | Professional | None | $776.25 | $977.24 | $1,698.24 |
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 $398.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $588.84 |
Where Illinois sits
The same service costs 20.9 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· 35th of 51
$977
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.