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 $4,677.35 Typical High $9,772.37 | Facility | None | $933.25 | $4,677.35 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,365.16 | $4,786.30 | $4,786.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $24,547.09 Median $52,480.75 Typical High $104,712.85 | Facility | None | $24,547.09 | $52,480.75 | $104,712.85 |
BCBS Illinois Setting Professional Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $8,317.64 | Professional | None | $4,786.30 | $6,456.54 | $8,317.64 |
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 $2,344.23 Median $5,888.44 Typical High $8,511.38 | Professional | None | $2,344.23 | $5,888.44 | $8,511.38 |
Hally Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,760.83 Typical High $19,498.45 | Professional | None | $4,073.80 | $6,760.83 | $19,498.45 |
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 $5,011.87 Median $5,754.40 Typical High $6,456.54 | Professional | None | $5,011.87 | $5,754.40 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $575.44 | Professional | None | $33.11 | $33.11 | $575.44 |
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 $4,168.69 Median $5,370.32 Typical High $9,120.11 | Professional | None | $4,168.69 | $5,370.32 | $9,120.11 |
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 $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,187.76 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,311.31 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,388.44 | $3,388.44 |
Where Illinois sits
The same service costs 21.9 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
$5,129
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.