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 $3,388.44 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,388.44 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,949.84 | $1,949.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,912.51 Typical High $25,118.86 | Facility | None | $5,623.41 | $8,912.51 | $25,118.86 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,454.71 | $3,388.44 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $776.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,819.70 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,884.03 | $4,786.30 |
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 $2,344.23 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,344.23 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $2,344.23 | Professional | None | $33.11 | $229.09 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,479.11 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,513.56 | $1,819.70 | $3,548.13 |
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 $851.14 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,348.96 |
Where Illinois sits
The same service costs 11.2 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
$1,995
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.