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 $4,570.88 Typical High $9,772.37 | Facility | None | $933.25 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,073.80 | $4,570.88 | $4,570.88 |
BCBS Illinois Setting Facility Modifier None Typical Low $23,442.29 Median $50,118.72 Typical High $100,000.00 | Facility | None | $23,442.29 | $50,118.72 | $100,000.00 |
BCBS Illinois Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
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 $3,981.07 Median $5,495.41 Typical High $7,943.28 | Professional | None | $3,981.07 | $5,495.41 | $7,943.28 |
Hally Health Setting Professional Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $15,848.93 | Professional | None | $4,265.80 | $6,456.54 | $15,848.93 |
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 $4,786.30 Median $5,495.41 Typical High $6,165.95 | Professional | None | $4,786.30 | $5,495.41 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
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 $3,890.45 Median $4,897.79 Typical High $8,511.38 | Professional | None | $3,890.45 | $4,897.79 | $8,511.38 |
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 $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $2,041.74 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,090.30 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,162.28 | $3,162.28 |
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· 33rd of 51
$4,571
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.