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 $2,951.21 Typical High $7,762.47 | Facility | None | $724.44 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | None | $660.69 | $724.44 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,754.40 Median $7,585.78 Typical High $10,964.78 | Facility | None | $5,754.40 | $7,585.78 | $10,964.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,318.26 | Professional | None | $831.76 | $1,148.15 | $1,318.26 |
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 $691.83 Median $724.44 Typical High $1,202.26 | Professional | None | $691.83 | $724.44 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,570.40 | Professional | None | $758.58 | $1,148.15 | $2,570.40 |
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 $851.14 Median $891.25 Typical High $1,000.00 | Professional | None | $851.14 | $891.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $794.33 | Professional | None | $33.11 | $77.62 | $794.33 |
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 $660.69 Median $776.25 Typical High $1,380.38 | Professional | None | $660.69 | $776.25 | $1,380.38 |
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 $331.13 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $501.19 |
Where Illinois sits
The same service costs 19.1 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· 40th 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.