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 $1,096.48 Median $3,801.89 Typical High $14,125.38 | Facility | None | $1,096.48 | $3,801.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,096.48 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,943.28 Median $16,982.44 Typical High $33,884.42 | Facility | None | $7,943.28 | $16,982.44 | $33,884.42 |
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 $1,174.90 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,258.93 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $5,128.61 | Professional | None | $1,096.48 | $1,698.24 | $5,128.61 |
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 $1,288.25 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,380.38 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $870.96 |
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· 31st of 51
$1,380
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.