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 $177.83 Median $1,288.25 Typical High $5,623.41 | Facility | None | $177.83 | $1,288.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | None | $134.90 | $162.18 | $177.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $1,905.46 | Facility | None | $204.17 | $309.03 | $1,905.46 |
BCBS Illinois Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $316.23 | Professional | None | $181.97 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $251.19 Typical High $363.08 | Facility | None | $138.04 | $251.19 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $302.00 | Professional | None | $165.96 | $199.53 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $524.81 | Professional | None | $181.97 | $257.04 | $524.81 |
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 $186.21 Median $190.55 Typical High $251.19 | Professional | None | $186.21 | $190.55 | $251.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $218.78 | Professional | None | $33.11 | $33.11 | $218.78 |
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 $144.54 Median $181.97 Typical High $316.23 | Professional | None | $144.54 | $181.97 | $316.23 |
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 $72.44 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $28.84 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $109.65 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $107.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $102.33 | $107.15 | $123.03 |
Where Illinois sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 25th of 51
$209
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.