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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $933.25 | $1,047.13 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $11,220.18 Typical High $16,595.87 | Facility | None | $7,413.10 | $11,220.18 | $16,595.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,659.59 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,709.64 Typical High $11,220.18 | Facility | None | $741.31 | $8,709.64 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,122.02 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $4,168.69 | Professional | None | $954.99 | $1,513.56 | $4,168.69 |
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 $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,202.26 | $1,288.25 |
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 $1,174.90 Median $3,090.30 Typical High $10,471.29 | Facility | None | $1,174.90 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,089.30 | Professional | None | $977.24 | $1,258.93 | $2,089.30 |
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 $467.74 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $758.58 |
Where Illinois sits
The same service costs 6.3 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· 24th 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.