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 $831.76 Median $3,311.31 Typical High $9,772.37 | Facility | None | $831.76 | $3,311.31 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $10,715.19 | Facility | None | $4,570.88 | $6,760.83 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $6,760.83 | Facility | None | $1,023.29 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,445.44 | Professional | None | $831.76 | $1,071.52 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $3,235.94 | Professional | None | $812.83 | $1,174.90 | $3,235.94 |
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 $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | None | $870.96 | $1,000.00 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $85.11 | Professional | None | $33.11 | $33.11 | $85.11 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $14,454.40 | Facility | None | $1,479.11 | $5,011.87 | $14,454.40 |
United Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,513.56 | Professional | None | $758.58 | $912.01 | $1,513.56 |
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 $380.19 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $575.44 |
Where Illinois sits
The same service costs 25.1 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· 33rd of 51
$871
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.