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 $831.76 Median $2,290.87 Typical High $7,762.47 | Facility | None | $831.76 | $2,290.87 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | None | $977.24 | $1,071.52 | $1,071.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $14,125.38 | Facility | None | $5,623.41 | $8,317.64 | $14,125.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,698.24 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,606.93 Typical High $8,317.64 | Facility | None | $776.25 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,202.26 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $5,011.87 | Professional | None | $1,148.15 | $1,737.80 | $5,011.87 |
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 $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,348.96 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $117.49 Typical High $1,202.26 | Professional | None | $33.11 | $117.49 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,041.74 | Professional | None | $977.24 | $1,202.26 | $2,041.74 |
4 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 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $758.58 |
Where Illinois sits
The same service costs 7.6 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· 34th of 51
$1,259
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.