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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $588.84 | Professional | None | $416.87 | $467.74 | $588.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $3,467.37 Median $5,128.61 Typical High $8,709.64 | Facility | None | $3,467.37 | $5,128.61 | $8,709.64 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $812.83 | Professional | None | $524.81 | $691.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,981.07 Typical High $5,128.61 | Facility | None | $660.69 | $3,981.07 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $831.76 | Professional | None | $457.09 | $524.81 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,737.80 | Professional | None | $512.86 | $794.33 | $1,737.80 |
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 $602.56 Median $616.60 Typical High $676.08 | Professional | None | $602.56 | $616.60 | $676.08 |
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 $1,047.13 Median $2,454.71 Typical High $7,762.47 | Facility | None | $1,047.13 | $2,454.71 | $7,762.47 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $977.24 | Professional | None | $457.09 | $575.44 | $977.24 |
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 $208.93 Median $234.42 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $338.84 |
Where Illinois sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 27th of 51
$676
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.