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 $2,344.23 Typical High $7,762.47 | Facility | None | $933.25 | $2,344.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,344.23 | $2,951.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $44,668.36 | Facility | None | $10,471.29 | $22,387.21 | $44,668.36 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,818.38 | $3,235.94 |
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 $2,089.30 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,630.27 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,606.93 | Professional | None | $1,905.46 | $3,019.95 | $6,606.93 |
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 $2,041.74 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,454.71 | $2,754.23 |
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 $2,089.30 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,951.21 | $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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,548.82 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,659.59 | $1,659.59 |
Where Illinois sits
The same service costs 5.1 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· 26th of 51
$2,630
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.