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 $331.13 Median $446.68 Typical High $724.44 | Professional | None | $331.13 | $446.68 | $724.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,754.23 Median $5,888.44 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,888.44 | $11,748.98 |
BCBS Illinois Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $758.58 | Professional | None | $524.81 | $724.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $1,995.26 | Facility | None | $512.86 | $645.65 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $812.83 | Professional | None | $416.87 | $512.86 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,479.11 | Professional | None | $426.58 | $676.08 | $1,479.11 |
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 $489.78 Median $549.54 Typical High $630.96 | Professional | None | $489.78 | $549.54 | $630.96 |
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 $398.11 Median $549.54 Typical High $933.25 | Professional | None | $398.11 | $549.54 | $933.25 |
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 $165.96 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $66.07 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $245.47 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $316.23 |
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· 22nd of 51
$603
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.