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 $2,691.53 Typical High $7,762.47 | Facility | None | $933.25 | $2,691.53 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,691.53 | $3,388.44 |
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 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,235.94 | $4,365.16 |
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 $1,819.70 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,819.70 | $2,630.27 | $4,365.16 |
Hally Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $7,413.10 | Professional | None | $1,995.26 | $3,388.44 | $7,413.10 |
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 $2,398.83 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,818.38 | $3,162.28 |
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 $2,137.96 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,137.96 | $3,235.94 | $5,128.61 |
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 $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,778.28 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $1,905.46 |
Where Illinois sits
The same service costs 5.2 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· 29th of 51
$2,692
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.