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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,445.44 | $1,479.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,943.28 Median $16,982.44 Typical High $33,884.42 | Facility | None | $7,943.28 | $16,982.44 | $33,884.42 |
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 $1,348.96 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,698.24 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $5,888.44 | Professional | None | $1,230.27 | $1,949.84 | $5,888.44 |
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 $1,380.38 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,584.89 | $1,778.28 |
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 $1,288.25 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,659.59 | $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 $562.34 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $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 $112.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $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 6.8 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· 28th of 51
$1,622
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.