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 $223.87 Median $1,318.26 Typical High $5,623.41 | Facility | None | $223.87 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $223.87 | Professional | None | $154.88 | $204.17 | $223.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $2,884.03 | Facility | None | $218.78 | $354.81 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $457.09 | Professional | None | $181.97 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $512.86 | Facility | None | $208.93 | $295.12 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $354.81 | Professional | None | $151.36 | $213.80 | $354.81 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $512.86 | Professional | None | $194.98 | $302.00 | $512.86 |
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 $190.55 Median $199.53 Typical High $302.00 | Professional | None | $190.55 | $199.53 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $331.13 | Professional | None | $33.11 | $33.11 | $331.13 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $380.19 | Professional | None | $162.18 | $218.78 | $380.19 |
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 $77.62 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $117.49 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $109.65 | $131.83 | $154.88 |
Where Illinois sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$224
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.