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 $758.58 Median $2,137.96 Typical High $7,762.47 | Facility | None | $758.58 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,202.26 | Professional | None | $741.31 | $831.76 | $1,202.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $10,964.78 | Facility | None | $2,630.27 | $4,168.69 | $10,964.78 |
BCBS Illinois Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,318.26 | Professional | None | $891.25 | $1,288.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $3,890.45 | Facility | None | $741.31 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,380.38 | Professional | None | $812.83 | $912.01 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $3,090.30 | Professional | None | $758.58 | $1,202.26 | $3,090.30 |
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 $933.25 Typical High $1,023.29 | Professional | None | $891.25 | $933.25 | $1,023.29 |
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 $1,288.25 Median $4,073.80 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,073.80 | $10,471.29 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,659.59 | Professional | None | $776.25 | $1,000.00 | $1,659.59 |
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 $371.54 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $602.56 |
Where Illinois sits
The same service costs 7.9 times more in Oklahoma 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· 21st of 51
$1,202
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.