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 $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $13,489.63 Typical High $26,915.35 | Facility | None | $6,309.57 | $13,489.63 | $26,915.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,737.80 | $2,344.23 |
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 $1,258.93 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,737.80 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $4,897.79 | Professional | None | $1,148.15 | $1,819.70 | $4,897.79 |
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 $1,288.25 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,479.11 | $1,659.59 |
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 $1,778.28 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,778.28 | $2,691.53 |
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 $630.96 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,000.00 |
Where Illinois sits
The same service costs 5.6 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· 21st of 51
$1,698
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.