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 $2,398.83 Typical High $7,762.47 | Facility | None | $933.25 | $2,398.83 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,398.83 | $3,019.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,715.19 Median $22,908.68 Typical High $45,708.82 | Facility | None | $10,715.19 | $22,908.68 | $45,708.82 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,454.71 | $2,884.03 | $3,981.07 |
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 $2,137.96 Median $2,818.38 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,818.38 | $3,981.07 |
Hally Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $7,943.28 | Professional | None | $1,949.84 | $3,090.30 | $7,943.28 |
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 $2,137.96 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,511.89 | $2,818.38 |
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 $3,019.95 Typical High $4,570.88 | Professional | None | $2,137.96 | $3,019.95 | $4,570.88 |
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 $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,071.52 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,698.24 | $1,698.24 |
Where Illinois sits
The same service costs 6.2 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· 24th 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.