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 $812.83 Median $3,890.45 Typical High $14,125.38 | Facility | None | $812.83 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,122.02 | Professional | None | $691.83 | $758.58 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,964.78 | Facility | None | $4,570.88 | $6,760.83 | $10,964.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,412.54 | Professional | None | $870.96 | $1,174.90 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,258.93 | Professional | None | $676.08 | $758.58 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $5,370.32 | Professional | None | $794.33 | $1,174.90 | $5,370.32 |
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 $891.25 Median $933.25 Typical High $1,023.29 | Professional | None | $891.25 | $933.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $81.28 Typical High $831.76 | Professional | None | $33.11 | $81.28 | $831.76 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,479.11 | Professional | None | $660.69 | $794.33 | $1,479.11 |
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 $346.74 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $524.81 |
Where Illinois sits
The same service costs 17.4 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· 36th of 51
$832
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.