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 $724.44 Median $3,235.94 Typical High $7,762.47 | Facility | None | $724.44 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | None | $616.60 | $660.69 | $660.69 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,232.93 | Facility | None | $4,570.88 | $6,760.83 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,202.26 | Professional | None | $758.58 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,122.02 | Professional | None | $524.81 | $691.83 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $2,818.38 | Professional | None | $660.69 | $1,047.13 | $2,818.38 |
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 $794.33 Median $831.76 Typical High $912.01 | Professional | None | $794.33 | $831.76 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $724.44 | Professional | None | $33.11 | $70.79 | $724.44 |
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 $575.44 Median $812.83 Typical High $1,288.25 | Professional | None | $575.44 | $812.83 | $1,288.25 |
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 $309.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $467.74 |
Where Illinois sits
The same service costs 8.1 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
$776
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.