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 $2,187.76 Typical High $7,762.47 | Facility | None | $933.25 | $2,187.76 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,187.76 | $2,398.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,022.64 Median $25,703.96 Typical High $51,286.14 | Facility | None | $12,022.64 | $25,703.96 | $51,286.14 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,187.76 | $3,467.37 |
Hally Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $9,120.11 | Professional | None | $1,949.84 | $2,951.21 | $9,120.11 |
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 $2,290.87 Median $2,398.83 Typical High $2,630.27 | Professional | None | $2,290.87 | $2,398.83 | $2,630.27 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,454.71 | $4,365.16 |
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 $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $870.96 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,288.25 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,548.82 | $1,548.82 |
Where Illinois sits
The same service costs 7.8 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
$2,188
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.