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 $501.19 Median $2,630.27 Typical High $7,762.47 | Facility | None | $501.19 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $512.86 | Professional | None | $323.59 | $416.87 | $512.86 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,122.02 | $1,778.28 | $4,677.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $812.83 | Professional | None | $407.38 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,737.80 | Facility | None | $851.14 | $1,348.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $776.25 | Professional | None | $457.09 | $549.54 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,513.56 | Professional | None | $467.74 | $707.95 | $1,513.56 |
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 $446.68 Median $457.09 Typical High $691.83 | Professional | None | $446.68 | $457.09 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $575.44 | Professional | None | $33.11 | $56.23 | $575.44 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,071.52 Typical High $3,890.45 | Facility | None | $446.68 | $1,071.52 | $3,890.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $912.01 | Professional | None | $380.19 | $537.03 | $912.01 |
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 $177.83 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $177.83 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $70.79 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $354.81 |
Where Illinois sits
The same service costs 4.8 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· 28th of 51
$550
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.