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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $645.65 | Professional | None | $398.11 | $398.11 | $645.65 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $6,606.93 | Facility | None | $2,630.27 | $3,801.89 | $6,606.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $851.14 | Professional | None | $489.78 | $724.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $3,890.45 | Facility | None | $630.96 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $758.58 | Professional | None | $416.87 | $467.74 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,621.81 | Professional | None | $407.38 | $630.96 | $1,621.81 |
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 $478.63 Median $501.19 Typical High $549.54 | Professional | None | $478.63 | $501.19 | $549.54 |
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 $1,047.13 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,454.71 | $7,585.78 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $870.96 | Professional | None | $416.87 | $575.44 | $870.96 |
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 $199.53 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $316.23 |
Where Illinois sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 24th of 51
$631
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.