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 $831.76 Median $2,187.76 Typical High $7,762.47 | Facility | None | $831.76 | $2,187.76 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,623.41 | $8,317.64 | $13,489.63 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,479.11 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $8,317.64 | Facility | None | $741.31 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,412.54 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $3,388.44 | Professional | None | $1,000.00 | $1,548.82 | $3,388.44 |
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 $1,071.52 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,174.90 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $102.33 Typical High $1,047.13 | Professional | None | $33.11 | $102.33 | $1,047.13 |
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 $851.14 Median $1,023.29 Typical High $1,905.46 | Professional | None | $851.14 | $1,023.29 | $1,905.46 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Where Illinois sits
The same service costs 14.5 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· 24th of 51
$1,349
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.