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 $1,905.46 Typical High $7,762.47 | Facility | None | $758.58 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,047.13 | Professional | None | $724.44 | $831.76 | $1,047.13 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,128.61 Median $10,964.78 Typical High $21,877.62 | Facility | None | $5,128.61 | $10,964.78 | $21,877.62 |
BCBS Illinois Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,479.11 | Professional | None | $933.25 | $1,318.26 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,548.82 | Professional | None | $851.14 | $977.24 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,019.95 | Professional | None | $851.14 | $1,318.26 | $3,019.95 |
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 $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | None | $977.24 | $1,071.52 | $1,174.90 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,819.70 | Professional | None | $831.76 | $1,096.48 | $1,819.70 |
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 $363.08 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $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 $109.65 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $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 6.3 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· 34th of 51
$1,023
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.