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 $1,513.56 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,737.80 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,585.78 Median $16,218.10 Typical High $32,359.37 | Facility | None | $7,585.78 | $16,218.10 | $32,359.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,089.30 | $2,884.03 |
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 $1,513.56 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,041.74 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $8,511.38 | Professional | None | $1,380.38 | $2,187.76 | $8,511.38 |
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 $1,548.82 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,778.28 | $1,995.26 |
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 $1,513.56 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,187.76 | $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 $758.58 Median $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,202.26 |
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· 27th of 51
$1,995
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.