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 $331.13 Median $1,202.26 Typical High $5,888.44 | Facility | None | $331.13 | $1,202.26 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $660.69 | Professional | None | $331.13 | $446.68 | $660.69 |
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 $537.03 Median $724.44 Typical High $776.25 | Professional | None | $537.03 | $724.44 | $776.25 |
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 $436.52 Median $524.81 Typical High $812.83 | Professional | None | $436.52 | $524.81 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,737.80 | Professional | None | $426.58 | $691.83 | $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 $478.63 Median $549.54 Typical High $630.96 | Professional | None | $478.63 | $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 $562.34 Typical High $954.99 | Professional | None | $398.11 | $562.34 | $954.99 |
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 $239.88 | Professional | 52 · Reduced service | $165.96 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $331.13 |
Where Illinois sits
The same service costs 5.0 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· 19th of 51
$617
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.