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 $1,949.84 Typical High $7,762.47 | Facility | None | $933.25 | $1,949.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,737.80 | $1,949.84 | $3,090.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,709.64 Median $18,620.87 Typical High $37,153.52 | Facility | None | $8,709.64 | $18,620.87 | $37,153.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,344.23 | $2,630.27 |
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 $1,737.80 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,344.23 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $5,370.32 | Professional | None | $1,548.82 | $2,511.89 | $5,370.32 |
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 $1,737.80 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,737.80 | $2,041.74 | $2,290.87 |
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 $1,737.80 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,398.83 | $3,715.35 |
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 $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,380.38 |
Where Illinois sits
The same service costs 5.5 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· 20th of 51
$2,344
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.