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 $269.15 Median $1,348.96 Typical High $5,623.41 | Facility | None | $269.15 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $269.15 | Professional | None | $169.82 | $245.47 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,122.02 | $1,659.59 | $2,884.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $537.03 | Professional | None | $190.55 | $316.23 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,348.96 Typical High $1,659.59 | Facility | None | $478.63 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $407.38 | Professional | None | $208.93 | $288.40 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $676.08 | Professional | None | $223.87 | $363.08 | $676.08 |
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 $208.93 Median $218.78 Typical High $363.08 | Professional | None | $208.93 | $218.78 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $3,890.45 | Facility | None | $446.68 | $1,047.13 | $3,890.45 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $467.74 | Professional | None | $173.78 | $263.03 | $467.74 |
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 $85.11 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $162.18 | $190.55 |
Where Illinois sits
The same service costs 4.1 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
$275
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.