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 $812.83 Median $1,905.46 Typical High $5,888.44 | Facility | None | $812.83 | $1,905.46 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,698.24 | $1,698.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $21,877.62 | Facility | None | $2,511.89 | $3,981.07 | $21,877.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,630.27 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,884.03 Typical High $3,715.35 | Facility | None | $630.96 | $2,884.03 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,698.24 | $1,949.84 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $7,943.28 | Professional | None | $1,737.80 | $2,630.27 | $7,943.28 |
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 $1,905.46 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,905.46 | $2,089.30 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $2,041.74 | Professional | None | $33.11 | $181.97 | $2,041.74 |
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 $1,513.56 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,819.70 | $3,162.28 |
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 $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 7.8 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· 34th of 51
$1,950
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.