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 $616.60 Median $1,949.84 Typical High $5,623.41 | Facility | None | $616.60 | $1,949.84 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,202.26 Typical High $1,778.28 | Professional | None | $398.11 | $1,202.26 | $1,778.28 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $6,606.93 | Facility | None | $2,454.71 | $3,630.78 | $6,606.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $1,445.44 Typical High $2,754.23 | Professional | None | $489.78 | $1,445.44 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,630.78 | Facility | None | $741.31 | $2,884.03 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $2,137.96 | Professional | None | $436.52 | $851.14 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $1,584.89 Typical High $3,630.78 | Professional | None | $467.74 | $1,584.89 | $3,630.78 |
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 $436.52 Median $501.19 Typical High $1,584.89 | Professional | None | $436.52 | $501.19 | $1,584.89 |
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 $1,174.90 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,174.90 Typical High $2,511.89 | Professional | None | $426.58 | $1,174.90 | $2,511.89 |
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 $213.80 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $213.80 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $85.11 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $316.23 | $741.31 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $63.10 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $42.66 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $295.12 | $691.83 | $1,023.29 |
Where Illinois sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,445
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.