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 $1,348.96 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,548.82 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,760.83 Median $14,454.40 Typical High $28,840.32 | Facility | None | $6,760.83 | $14,454.40 | $28,840.32 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,819.70 | $2,137.96 |
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 $1,348.96 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,778.28 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,230.27 | $2,041.74 | $4,897.79 |
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 $1,348.96 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,584.89 | $1,778.28 |
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 $1,348.96 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,905.46 | $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 $676.08 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,071.52 |
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· 26th of 51
$1,778
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.