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 $549.54 Median $1,819.70 Typical High $5,623.41 | Facility | None | $549.54 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $602.56 | Professional | None | $346.74 | $549.54 | $602.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,168.69 Median $5,888.44 Typical High $8,912.51 | Facility | None | $4,168.69 | $5,888.44 | $8,912.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,071.52 | Professional | None | $457.09 | $630.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,760.83 | Facility | None | $630.96 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $954.99 | Professional | None | $338.84 | $426.58 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $3,019.95 | Professional | None | $436.52 | $794.33 | $3,019.95 |
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 $436.52 Median $446.68 Typical High $812.83 | Professional | None | $436.52 | $446.68 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $758.58 | Professional | None | $33.11 | $69.18 | $758.58 |
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 $380.19 Median $645.65 Typical High $1,122.02 | Professional | None | $380.19 | $645.65 | $1,122.02 |
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 $173.78 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $173.78 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $69.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $257.04 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $52.48 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $363.08 | $416.87 |
Where Illinois sits
The same service costs 4.9 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· 38th of 51
$575
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.