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 $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,318.26 | $1,412.54 | $1,412.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $18,197.01 | Facility | None | $5,754.40 | $8,128.31 | $18,197.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,623.41 | Professional | None | $4,897.79 | $5,128.61 | $5,623.41 |
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 $1,380.38 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,445.44 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $6,309.57 | Professional | None | $1,479.11 | $2,238.72 | $6,309.57 |
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 $1,698.24 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,778.28 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $147.91 Typical High $1,513.56 | Professional | None | $33.11 | $147.91 | $1,513.56 |
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 $1,258.93 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,584.89 | $2,818.38 |
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 $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $977.24 |
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· 34th of 51
$1,622
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.