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 $3,890.45 Typical High $14,125.38 | Facility | None | $933.25 | $3,890.45 | $14,125.38 |
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 $4,265.80 Median $9,120.11 Typical High $18,620.87 | Facility | None | $4,265.80 | $9,120.11 | $18,620.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,445.44 | Professional | None | $954.99 | $1,122.02 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | None | $851.14 | $1,071.52 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $4,168.69 | Professional | None | $812.83 | $1,202.26 | $4,168.69 |
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 $891.25 Median $1,000.00 Typical High $1,148.15 | Professional | None | $891.25 | $1,000.00 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $109.65 | Professional | None | $33.11 | $33.11 | $109.65 |
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 $776.25 Median $912.01 Typical High $1,548.82 | Professional | None | $776.25 | $912.01 | $1,548.82 |
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 $575.44 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $125.89 |
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 $537.03 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $588.84 |
Where Illinois sits
The same service costs 5.9 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· 32nd of 51
$891
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.