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 $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,479.11 | $1,659.59 | $1,659.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,511.38 Median $18,197.01 Typical High $36,307.81 | Facility | None | $8,511.38 | $18,197.01 | $36,307.81 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,238.72 | $3,467.37 |
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 $1,995.26 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,995.26 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $5,888.44 | Professional | None | $1,548.82 | $2,344.23 | $5,888.44 |
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 $1,737.80 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,995.26 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $213.80 | Professional | None | $33.11 | $33.11 | $213.80 |
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 $1,479.11 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,737.80 | $3,090.30 |
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 $741.31 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,148.15 |
Where Illinois sits
The same service costs 5.1 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
$1,660
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.