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 $933.25 Median $3,235.94 Typical High $7,762.47 | Facility | None | $933.25 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,230.27 | Professional | None | $741.31 | $933.25 | $1,230.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $11,220.18 | Facility | None | $4,570.88 | $6,760.83 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $891.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Professional | None | $776.25 | $933.25 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $3,019.95 | Professional | None | $831.76 | $1,288.25 | $3,019.95 |
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 $977.24 Median $1,023.29 Typical High $1,122.02 | Professional | None | $977.24 | $1,023.29 | $1,122.02 |
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 $776.25 Median $1,000.00 Typical High $1,778.28 | Professional | None | $776.25 | $1,000.00 | $1,778.28 |
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 $371.54 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $660.69 | $660.69 |
Where Illinois sits
The same service costs 7.4 times more in Oklahoma 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· 26th of 51
$1,175
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.