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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,762.47 Median $16,595.87 Typical High $33,113.11 | Facility | None | $7,762.47 | $16,595.87 | $33,113.11 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,041.74 | $3,162.28 |
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 $1,412.54 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,905.46 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $6,760.83 | Professional | None | $1,479.11 | $2,137.96 | $6,760.83 |
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 $1,584.89 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,819.70 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $199.53 | Professional | None | $33.11 | $33.11 | $199.53 |
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 $1,412.54 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,659.59 | $2,818.38 |
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 $691.83 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $691.83 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,047.13 |
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· 32nd of 51
$1,585
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.