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 $398.11 Median $1,148.15 Typical High $5,623.41 | Facility | None | $398.11 | $1,148.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $416.87 | Professional | None | $251.19 | $269.15 | $416.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,548.13 | Facility | None | $1,318.26 | $1,949.84 | $3,548.13 |
BCBS Illinois Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $524.81 | Professional | None | $316.23 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,089.30 | Facility | None | $741.31 | $1,584.89 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $602.56 | Professional | None | $338.84 | $489.78 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $1,000.00 | Professional | None | $323.59 | $489.78 | $1,000.00 |
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 $338.84 Median $354.81 Typical High $426.58 | Professional | None | $338.84 | $354.81 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $363.08 | Professional | None | $33.11 | $35.48 | $363.08 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,511.89 | $5,888.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $588.84 | Professional | None | $275.42 | $338.84 | $588.84 |
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 $131.83 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $186.21 | $199.53 | $213.80 |
Where Illinois sits
The same service costs 6.8 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· 24th of 51
$407
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.