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 $457.09 Median $1,737.80 Typical High $5,623.41 | Facility | None | $457.09 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $457.09 | Professional | None | $331.13 | $416.87 | $457.09 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $8,511.38 | Facility | None | $3,630.78 | $5,754.40 | $8,511.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $660.69 | Professional | None | $363.08 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $6,760.83 | Facility | None | $630.96 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $776.25 | Professional | None | $380.19 | $467.74 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,412.54 | Professional | None | $371.54 | $588.84 | $1,412.54 |
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 $389.05 Median $407.38 Typical High $602.56 | Professional | None | $389.05 | $407.38 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $61.66 | Professional | None | $33.11 | $33.11 | $61.66 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $831.76 | Professional | None | $354.81 | $478.63 | $831.76 |
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 $165.96 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $165.96 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $66.07 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $316.23 |
Where Illinois sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 33rd of 51
$457
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.