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 $2,041.74 Typical High $7,762.47 | Facility | None | $933.25 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,041.74 | $2,511.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,912.51 Median $19,498.45 Typical High $38,904.51 | Facility | None | $8,912.51 | $19,498.45 | $38,904.51 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,454.71 | $3,311.31 |
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 $1,819.70 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,187.76 | $3,311.31 |
Hally Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $6,918.31 | Professional | None | $1,621.81 | $2,570.40 | $6,918.31 |
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 $1,778.28 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,778.28 | $2,137.96 | $2,398.83 |
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 $1,819.70 Median $2,754.23 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,754.23 | $3,890.45 |
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 $891.25 Median $1,023.29 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $407.38 Typical High $416.87 | Professional | 53 · Discontinued | $363.08 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $204.17 Typical High $208.93 | Professional | 56 · Pre-op care only | $181.97 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,412.54 | $1,445.44 |
Where Illinois sits
The same service costs 5.8 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· 28th of 51
$2,239
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.