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 $467.74 Median $1,862.09 Typical High $5,888.44 | Facility | None | $467.74 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $263.03 | Professional | None | $158.49 | $181.97 | $263.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,365.16 | Facility | None | $1,862.09 | $2,511.89 | $4,365.16 |
BCBS Illinois Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $316.23 | Professional | None | $213.80 | $281.84 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,290.87 Typical High $2,818.38 | Facility | None | $776.25 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $323.59 | Professional | None | $194.98 | $208.93 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $645.65 | Professional | None | $186.21 | $281.84 | $645.65 |
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 $213.80 Median $229.09 Typical High $251.19 | Professional | None | $213.80 | $229.09 | $251.19 |
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 $676.08 Median $1,513.56 Typical High $4,466.84 | Facility | None | $676.08 | $1,513.56 | $4,466.84 |
United Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $389.05 | Professional | None | $173.78 | $223.87 | $389.05 |
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 $77.62 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $77.62 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $31.62 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $109.65 | $125.89 | $125.89 |
Where Illinois sits
The same service costs 8.7 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· 25th of 51
$282
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.