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 $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,479.11 | $1,584.89 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $20,417.38 | Facility | None | $5,754.40 | $8,128.31 | $20,417.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $6,456.54 | Professional | None | $5,623.41 | $5,888.44 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,760.83 Typical High $8,709.64 | Facility | None | $776.25 | $6,760.83 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,659.59 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $10,232.93 | Professional | None | $1,659.59 | $2,570.40 | $10,232.93 |
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 $1,949.84 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,949.84 | $1,995.26 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $169.82 Typical High $1,737.80 | Professional | None | $33.11 | $169.82 | $1,737.80 |
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 $1,445.44 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,862.09 | $3,162.28 |
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 $741.31 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,122.02 |
Where Illinois sits
The same service costs 19.5 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· 33rd of 51
$1,905
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.