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 $933.25 Median $2,951.21 Typical High $7,762.47 | Facility | None | $933.25 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,951.21 | $3,388.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $17,378.01 Median $37,153.52 Typical High $75,857.76 | Facility | None | $17,378.01 | $37,153.52 | $75,857.76 |
BCBS Illinois Setting Professional Modifier None Typical Low $4,265.80 Median $4,677.35 Typical High $7,943.28 | Professional | None | $4,265.80 | $4,677.35 | $7,943.28 |
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 $2,137.96 Median $3,890.45 Typical High $5,623.41 | Professional | None | $2,137.96 | $3,890.45 | $5,623.41 |
Hally Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,365.16 Typical High $10,964.78 | Professional | None | $2,570.40 | $4,365.16 | $10,964.78 |
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 $2,884.03 Median $3,548.13 Typical High $4,168.69 | Professional | None | $2,884.03 | $3,548.13 | $4,168.69 |
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 $2,630.27 Median $4,073.80 Typical High $6,309.57 | Professional | None | $2,630.27 | $4,073.80 | $6,309.57 |
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 $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,819.70 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,041.74 | $2,041.74 |
Where Illinois sits
The same service costs 17.0 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· 28th of 51
$3,236
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.