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 $2,691.53 Typical High $7,762.47 | Facility | None | $933.25 | $2,691.53 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,691.53 | $3,235.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $17,378.01 Median $37,153.52 Typical High $75,857.76 | Facility | None | $17,378.01 | $37,153.52 | $75,857.76 |
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 $1,659.59 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,659.59 | $2,754.23 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $8,912.51 | Professional | None | $1,949.84 | $3,311.31 | $8,912.51 |
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 $2,398.83 Median $2,754.23 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,754.23 | $3,090.30 |
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 $1,949.84 Median $2,951.21 Typical High $5,011.87 | Professional | None | $1,949.84 | $2,951.21 | $5,011.87 |
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 $1,122.02 Median $1,318.26 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,698.24 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,862.09 | $1,862.09 |
Where Illinois sits
The same service costs 6.2 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· 21st of 51
$2,692
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.