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 $3,311.31 Typical High $9,332.54 | Facility | None | $1,023.29 | $3,311.31 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,445.44 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $16,982.44 | Facility | None | $4,570.88 | $7,079.46 | $16,982.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,445.44 | $2,041.74 | $2,238.72 |
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 $1,288.25 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,445.44 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $4,677.35 | Professional | None | $1,288.25 | $1,995.26 | $4,677.35 |
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 $1,513.56 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,584.89 | $1,737.80 |
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 $1,202.26 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,584.89 | $2,818.38 |
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 $575.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $229.09 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $169.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $794.33 | $1,023.29 | $1,023.29 |
Where Illinois sits
The same service costs 6.6 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· 24th of 51
$1,862
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.