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 $478.63 Median $1,258.93 Typical High $5,888.44 | Facility | None | $478.63 | $1,258.93 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $776.25 | Professional | None | $478.63 | $616.60 | $776.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $6,165.95 | Facility | None | $194.98 | $295.12 | $6,165.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,412.54 | Professional | None | $537.03 | $851.14 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $263.03 Typical High $812.83 | Facility | None | $181.97 | $263.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,122.02 | Professional | None | $549.54 | $660.69 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,778.28 | Professional | None | $630.96 | $933.25 | $1,778.28 |
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 $588.84 Median $616.60 Typical High $933.25 | Professional | None | $588.84 | $616.60 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $977.24 | Professional | None | $33.11 | $33.11 | $977.24 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,230.27 | Professional | None | $537.03 | $794.33 | $1,230.27 |
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 $239.88 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $239.88 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $95.50 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $457.09 |
Where Illinois sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 36th of 51
$676
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.