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 $331.13 Median $1,288.25 Typical High $5,623.41 | Facility | None | $331.13 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $501.19 | Professional | None | $229.09 | $323.59 | $501.19 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $4,073.80 | Facility | None | $204.17 | $309.03 | $4,073.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $630.96 | Professional | None | $389.05 | $524.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $275.42 Typical High $512.86 | Facility | None | $190.55 | $275.42 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $588.84 | Professional | None | $302.00 | $389.05 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $1,071.52 | Professional | None | $346.74 | $512.86 | $1,071.52 |
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 $380.19 Median $398.11 Typical High $478.63 | Professional | None | $380.19 | $398.11 | $478.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $426.58 | Professional | None | $33.11 | $42.66 | $426.58 |
United Setting Facility Modifier None Typical Low $141.25 Median $501.19 Typical High $1,819.70 | Facility | None | $141.25 | $501.19 | $1,819.70 |
United Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $616.60 | Professional | None | $288.40 | $354.81 | $616.60 |
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 $144.54 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $199.53 | $218.78 | $234.42 |
Where Illinois sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 29th of 51
$389
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.