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 $776.25 Median $2,630.27 Typical High $7,762.47 | Facility | None | $776.25 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,174.90 | Professional | None | $691.83 | $776.25 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,073.80 Typical High $10,232.93 | Facility | None | $2,630.27 | $4,073.80 | $10,232.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | None | $851.14 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,890.45 | Facility | None | $891.25 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,318.26 | Professional | None | $758.58 | $812.83 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,290.87 | Professional | None | $707.95 | $1,122.02 | $2,290.87 |
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 $831.76 Median $891.25 Typical High $954.99 | Professional | None | $831.76 | $891.25 | $954.99 |
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 $8,511.38 | Facility | None | $1,174.90 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,548.82 | Professional | None | $707.95 | $933.25 | $1,548.82 |
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 $346.74 Median $389.05 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $562.34 |
Where Illinois sits
The same service costs 5.8 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· 22nd of 51
$1,096
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.