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 $114.82 Median $1,318.26 Typical High $5,623.41 | Facility | None | $114.82 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | None | $81.28 | $102.33 | $123.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $1,288.25 | Facility | None | $125.89 | $204.17 | $1,288.25 |
BCBS Illinois Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $204.17 | Professional | None | $123.03 | $165.96 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $251.19 | Facility | None | $87.10 | $158.49 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $194.98 | Professional | None | $125.89 | $169.82 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $380.19 | Professional | None | $125.89 | $177.83 | $380.19 |
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 $128.82 Median $131.83 Typical High $162.18 | Professional | None | $128.82 | $131.83 | $162.18 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $33.11 Typical High $138.04 | Professional | None | $28.84 | $33.11 | $138.04 |
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 $95.50 Median $120.23 Typical High $208.93 | Professional | None | $95.50 | $120.23 | $208.93 |
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 $48.98 Median $52.48 Typical High $56.23 | Professional | 52 · Reduced service | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 54 · Surgery only | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $72.44 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $69.18 | $72.44 | $79.43 |
Where Illinois sits
The same service costs 4.5 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· 24th of 51
$145
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.