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 $363.08 Median $1,698.24 Typical High $5,623.41 | Facility | None | $363.08 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $371.54 | Professional | None | $223.87 | $302.00 | $371.54 |
BCBS Illinois Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $3,162.28 | Facility | None | $363.08 | $588.84 | $3,162.28 |
BCBS Illinois Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $602.56 | Professional | None | $288.40 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $812.83 | Facility | None | $338.84 | $478.63 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $575.44 | Professional | None | $323.59 | $426.58 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $870.96 | Professional | None | $331.13 | $524.81 | $870.96 |
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 $309.03 Median $316.23 Typical High $501.19 | Professional | None | $309.03 | $316.23 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $416.87 | Professional | None | $33.11 | $41.69 | $416.87 |
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 $257.04 Median $380.19 Typical High $660.69 | Professional | None | $257.04 | $380.19 | $660.69 |
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 $120.23 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $169.82 | $223.87 | $257.04 |
Where Illinois sits
The same service costs 4.3 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· 28th of 51
$398
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.