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 $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,659.59 | $1,659.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $13,803.84 Median $19,498.45 Typical High $30,199.52 | Facility | None | $13,803.84 | $19,498.45 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,570.40 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,218.10 Typical High $20,892.96 | Facility | None | $776.25 | $16,218.10 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,659.59 | $1,862.09 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $6,165.95 | Professional | None | $1,737.80 | $2,630.27 | $6,165.95 |
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 $1,905.46 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 $177.83 Typical High $1,819.70 | Professional | None | $33.11 | $177.83 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $7,585.78 Typical High $25,703.96 | Facility | None | $1,659.59 | $7,585.78 | $25,703.96 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,819.70 | $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 $758.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 20.4 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· 34th of 51
$1,905
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.