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 $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,621.81 | $1,621.81 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,772.37 Typical High $20,892.96 | Facility | None | $7,079.46 | $9,772.37 | $20,892.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,511.89 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $8,317.64 Typical High $10,471.29 | Facility | None | $776.25 | $8,317.64 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,659.59 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $9,120.11 | Professional | None | $1,698.24 | $2,511.89 | $9,120.11 |
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 $1,862.09 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,862.09 | $2,041.74 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $1,819.70 | Professional | None | $33.11 | $173.78 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,778.28 | $3,235.94 |
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 $724.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,148.15 |
Where Illinois sits
The same service costs 8.9 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
$1,862
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.