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 $1,023.29 Median $3,388.44 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,388.44 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,348.96 | $1,479.11 | $1,479.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $19,054.61 | Facility | None | $1,318.26 | $2,041.74 | $19,054.61 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,698.24 | $2,290.87 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,089.30 | Facility | None | $977.24 | $1,584.89 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,548.82 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $5,370.32 | Professional | None | $1,513.56 | $2,238.72 | $5,370.32 |
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 $1,659.59 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,819.70 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $158.49 Typical High $1,621.81 | Professional | None | $33.11 | $158.49 | $1,621.81 |
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 $1,288.25 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,548.82 | $2,754.23 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,023.29 |
Where Illinois sits
The same service costs 17.0 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
$1,549
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.