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 $1,380.38 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,548.82 | $2,454.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,918.31 Median $14,791.08 Typical High $29,512.09 | Facility | None | $6,918.31 | $14,791.08 | $29,512.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,905.46 | $2,089.30 |
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 $1,380.38 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,584.89 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $4,365.16 | Professional | None | $1,230.27 | $1,949.84 | $4,365.16 |
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 $1,412.54 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,621.81 | $1,819.70 |
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 $1,318.26 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,862.09 | $2,951.21 |
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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,096.48 |
Where Illinois sits
The same service costs 4.8 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
$1,862
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.