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 $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $9,772.37 Typical High $22,908.68 | Facility | None | $7,079.46 | $9,772.37 | $22,908.68 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $3,235.94 | Professional | None | $1,995.26 | $2,691.53 | $3,235.94 |
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 $1,778.28 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,089.30 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $9,332.54 | Professional | None | $1,862.09 | $2,754.23 | $9,332.54 |
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 $1,995.26 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,995.26 | $2,187.76 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $186.21 Typical High $1,905.46 | Professional | None | $33.11 | $186.21 | $1,905.46 |
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 $1,584.89 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,949.84 | $3,467.37 |
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 $794.33 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $794.33 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,230.27 |
Where Illinois sits
The same service costs 9.3 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
$2,089
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.