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 $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $10,471.29 | Facility | None | $4,786.30 | $7,244.36 | $10,471.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $776.25 | Professional | None | $478.63 | $660.69 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $8,317.64 | Facility | None | $741.31 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $707.95 | Professional | None | $426.58 | $588.84 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,548.82 | Professional | None | $426.58 | $645.65 | $1,548.82 |
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 $467.74 Median $501.19 Typical High $562.34 | Professional | None | $467.74 | $501.19 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $44.67 Typical High $457.09 | Professional | None | $33.11 | $44.67 | $457.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $794.33 | Professional | None | $354.81 | $426.58 | $794.33 |
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 $181.97 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $275.42 |
Where Illinois sits
The same service costs 7.2 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· 24th 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.