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 $812.83 Median $3,890.45 Typical High $14,125.38 | Facility | None | $812.83 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $741.31 | Professional | None | $691.83 | $724.44 | $741.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,232.93 | Facility | None | $4,570.88 | $6,760.83 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,202.26 | Professional | None | $724.44 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,380.38 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,202.26 | Professional | None | $758.58 | $870.96 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $4,073.80 | Professional | None | $741.31 | $1,047.13 | $4,073.80 |
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 $831.76 Median $891.25 Typical High $977.24 | Professional | None | $831.76 | $891.25 | $977.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $91.20 | Professional | None | $33.11 | $33.11 | $91.20 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,380.38 | Professional | None | $707.95 | $831.76 | $1,380.38 |
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 $338.84 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $512.86 |
Where Illinois sits
The same service costs 6.3 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· 31st of 51
$832
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.