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 $602.56 Median $1,621.81 Typical High $7,762.47 | Facility | None | $602.56 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | None | $562.34 | $602.56 | $602.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $6,606.93 | Facility | None | $1,000.00 | $1,621.81 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,202.26 Typical High $1,513.56 | Facility | None | $489.78 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $2,187.76 | Professional | None | $588.84 | $870.96 | $2,187.76 |
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 $645.65 Median $741.31 Typical High $831.76 | Professional | None | $645.65 | $741.31 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $81.28 | Professional | None | $33.11 | $33.11 | $81.28 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,168.69 | Facility | None | $676.08 | $1,513.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,096.48 | Professional | None | $537.03 | $645.65 | $1,096.48 |
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 $275.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $426.58 |
Where Illinois sits
The same service costs 5.5 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· 30th of 51
$676
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.