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 $501.19 Median $1,258.93 Typical High $5,623.41 | Facility | None | $501.19 | $1,258.93 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | None | $457.09 | $501.19 | $501.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $6,606.93 | Facility | None | $1,318.26 | $2,041.74 | $6,606.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $977.24 | Professional | None | $602.56 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $1,949.84 | Facility | None | $478.63 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $870.96 | Professional | None | $501.19 | $575.44 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,905.46 | Professional | None | $537.03 | $812.83 | $1,905.46 |
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 $602.56 Median $630.96 Typical High $707.95 | Professional | None | $602.56 | $630.96 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $575.44 | Professional | None | $33.11 | $56.23 | $575.44 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,265.80 | Facility | None | $676.08 | $1,513.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $933.25 | Professional | None | $446.68 | $537.03 | $933.25 |
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 $229.09 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $354.81 |
Where Illinois sits
The same service costs 7.6 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
$589
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.