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 $3,235.94 Typical High $9,772.37 | Facility | None | $1,023.29 | $3,235.94 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,659.59 | $2,137.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $15,848.93 Typical High $31,622.78 | Facility | None | $7,413.10 | $15,848.93 | $31,622.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,737.80 | $2,041.74 | $2,754.23 |
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 $1,479.11 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,862.09 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,754.40 | Professional | None | $1,348.96 | $2,137.96 | $5,754.40 |
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 $1,737.80 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,737.80 | $1,949.84 |
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 $1,479.11 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,089.30 | $3,235.94 |
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 $741.31 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 5.4 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· 31st 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.