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 $602.56 Median $1,862.09 Typical High $5,888.44 | Facility | None | $602.56 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,318.26 Typical High $1,548.82 | Professional | None | $380.19 | $1,318.26 | $1,548.82 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $6,456.54 | Facility | None | $1,778.28 | $2,754.23 | $6,456.54 |
BCBS Illinois Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $3,019.95 | Professional | None | $812.83 | $812.83 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,187.76 Typical High $2,691.53 | Facility | None | $776.25 | $2,187.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,318.26 Typical High $2,570.40 | Professional | None | $446.68 | $1,318.26 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $1,737.80 Typical High $6,165.95 | Professional | None | $489.78 | $1,737.80 | $6,165.95 |
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 $457.09 Median $478.63 Typical High $1,737.80 | Professional | None | $457.09 | $478.63 | $1,737.80 |
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 $1,348.96 Median $4,168.69 Typical High $10,471.29 | Facility | None | $1,348.96 | $4,168.69 | $10,471.29 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,348.96 Typical High $3,235.94 | Professional | None | $446.68 | $1,348.96 | $3,235.94 |
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 $190.55 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $190.55 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $77.62 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $288.40 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $57.54 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $38.02 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $269.15 | $851.14 | $954.99 |
Where Illinois sits
The same service costs 4.9 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
$1,413
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.