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 $602.56 Median $1,819.70 Typical High $5,623.41 | Facility | None | $602.56 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $724.44 | Professional | None | $436.52 | $630.96 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,466.84 Median $6,165.95 Typical High $9,772.37 | Facility | None | $4,466.84 | $6,165.95 | $9,772.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $537.03 Median $870.96 Typical High $1,445.44 | Professional | None | $537.03 | $870.96 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,370.32 Typical High $6,760.83 | Facility | None | $630.96 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $1,096.48 | Professional | None | $257.04 | $489.78 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $891.25 Typical High $3,235.94 | Professional | None | $446.68 | $891.25 | $3,235.94 |
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 $537.03 Median $537.03 Typical High $933.25 | Professional | None | $537.03 | $537.03 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $831.76 | Professional | None | $33.11 | $83.18 | $831.76 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $1,174.90 | Professional | None | $346.74 | $602.56 | $1,174.90 |
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 $218.78 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $218.78 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $87.10 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $323.59 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $43.65 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $302.00 | $436.52 | $501.19 |
Where Illinois sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 31st of 51
$646
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.