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 $724.44 Median $2,951.21 Typical High $7,762.47 | Facility | None | $724.44 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $758.58 | Professional | None | $478.63 | $537.03 | $758.58 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,311.31 Median $7,079.46 Typical High $14,125.38 | Facility | None | $3,311.31 | $7,079.46 | $14,125.38 |
BCBS Illinois Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $977.24 | Professional | None | $660.69 | $870.96 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,000.00 | Professional | None | $524.81 | $630.96 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,905.46 | Professional | None | $562.34 | $851.14 | $1,905.46 |
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 $660.69 Median $691.83 Typical High $758.58 | Professional | None | $660.69 | $691.83 | $758.58 |
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 $2,884.03 Typical High $7,762.47 | Facility | None | $1,174.90 | $2,884.03 | $7,762.47 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,174.90 | Professional | None | $537.03 | $691.83 | $1,174.90 |
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 $234.42 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $389.05 |
Where Illinois sits
The same service costs 6.0 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· 31st of 51
$759
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.