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 $204.17 Median $1,096.48 Typical High $5,623.41 | Facility | None | $204.17 | $1,096.48 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $316.23 | Professional | None | $165.96 | $239.88 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $4,786.30 | Facility | None | $309.03 | $501.19 | $4,786.30 |
BCBS Illinois Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $436.52 | Professional | None | $173.78 | $269.15 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $549.54 | Facility | None | $288.40 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $407.38 | Professional | None | $158.49 | $218.78 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $691.83 | Professional | None | $173.78 | $323.59 | $691.83 |
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 $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
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 $676.08 Median $1,513.56 Typical High $4,677.35 | Facility | None | $676.08 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $512.86 | Professional | None | $177.83 | $288.40 | $512.86 |
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 $83.18 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $162.18 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $114.82 | $162.18 | $177.83 |
Where Illinois sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 32nd of 51
$282
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.