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 $1,479.11 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,659.59 | $2,041.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $15,848.93 Typical High $31,622.78 | Facility | None | $7,413.10 | $15,848.93 | $31,622.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,995.26 | $2,290.87 |
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 $1,479.11 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,862.09 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $5,128.61 | Professional | None | $1,318.26 | $2,089.30 | $5,128.61 |
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 $1,445.44 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,737.80 | $1,949.84 |
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 $1,479.11 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,479.11 | $2,041.74 | $3,162.28 |
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 $724.44 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $724.44 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $295.12 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,202.26 |
Where Illinois sits
The same service costs 4.9 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· 29th 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.