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 $323.59 Median $371.54 Typical High $562.34 | Professional | None | $323.59 | $371.54 | $562.34 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $5,754.40 | Facility | None | $2,630.27 | $3,890.45 | $5,754.40 |
BCBS Illinois Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $660.69 | Professional | None | $446.68 | $588.84 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,023.29 | $3,162.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $691.83 | Professional | None | $371.54 | $436.52 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,737.80 | Professional | None | $380.19 | $588.84 | $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 $436.52 Median $467.74 Typical High $524.81 | Professional | None | $436.52 | $467.74 | $524.81 |
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 $2,511.89 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $812.83 | Professional | None | $371.54 | $478.63 | $812.83 |
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 $162.18 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $239.88 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $257.04 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $257.04 | $263.03 |
Where Illinois sits
The same service costs 7.1 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· 24th of 51
$589
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.