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 $776.25 Median $2,137.96 Typical High $7,762.47 | Facility | None | $776.25 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $11,220.18 | Facility | None | $2,511.89 | $3,981.07 | $11,220.18 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,715.35 | Facility | None | $741.31 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,445.44 | Professional | None | $891.25 | $1,096.48 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $3,019.95 | Professional | None | $891.25 | $1,348.96 | $3,019.95 |
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 $1,000.00 Median $1,047.13 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,047.13 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $954.99 | Professional | None | $33.11 | $95.50 | $954.99 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,584.89 | Professional | None | $741.31 | $891.25 | $1,584.89 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $602.56 |
Where Illinois sits
The same service costs 7.4 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· 29th of 51
$1,072
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.