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 $1,023.29 Median $3,388.44 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,388.44 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,513.56 | $1,778.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $17,782.79 | Facility | None | $4,570.88 | $7,079.46 | $17,782.79 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,584.89 | $2,238.72 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,023.29 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,513.56 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $4,265.80 | Professional | None | $1,202.26 | $1,995.26 | $4,265.80 |
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 $1,584.89 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,621.81 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,584.89 | $2,884.03 |
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 $588.84 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $1,071.52 | $1,071.52 |
Where Illinois sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,950
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.