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 $295.12 Median $630.96 Typical High $5,128.61 | Facility | None | $295.12 | $630.96 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $478.63 | Professional | None | $239.88 | $269.15 | $478.63 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $3,467.37 | Facility | None | $204.17 | $309.03 | $3,467.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $645.65 | Professional | None | $331.13 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $363.08 | Facility | None | $141.25 | $251.19 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $512.86 | Professional | None | $229.09 | $302.00 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $933.25 | Professional | None | $288.40 | $436.52 | $933.25 |
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 $323.59 Median $338.84 Typical High $416.87 | Professional | None | $323.59 | $338.84 | $416.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $380.19 | Professional | None | $33.11 | $37.15 | $380.19 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $524.81 | Professional | None | $229.09 | $288.40 | $524.81 |
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 $123.03 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $173.78 | $186.21 | $208.93 |
Where Illinois sits
The same service costs 5.4 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· 30th of 51
$316
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.