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 $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,258.93 | $1,258.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,456.54 Median $13,803.84 Typical High $28,183.83 | Facility | None | $6,456.54 | $13,803.84 | $28,183.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,698.24 | $2,290.87 |
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 $1,071.52 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,548.82 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $5,011.87 | Professional | None | $1,202.26 | $1,819.70 | $5,011.87 |
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 $1,348.96 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,548.82 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $165.96 | Professional | None | $33.11 | $33.11 | $165.96 |
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 $1,148.15 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,380.38 | $2,344.23 |
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 $575.44 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $891.25 |
Where Illinois sits
The same service costs 5.4 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· 31st of 51
$1,349
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.