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 $2,630.27 Typical High $7,762.47 | Facility | None | $933.25 | $2,630.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,630.27 | $2,951.21 |
BCBS Illinois Setting Facility Modifier None Typical Low $15,488.17 Median $33,113.11 Typical High $66,069.34 | Facility | None | $15,488.17 | $33,113.11 | $66,069.34 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $6,606.93 | Professional | None | $3,311.31 | $3,311.31 | $6,606.93 |
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 $2,570.40 Median $3,467.37 Typical High $5,011.87 | Professional | None | $2,570.40 | $3,467.37 | $5,011.87 |
Hally Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,890.45 Typical High $9,549.93 | Professional | None | $2,398.83 | $3,890.45 | $9,549.93 |
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 $2,570.40 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,570.40 | $3,162.28 | $3,630.78 |
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 $2,454.71 Median $3,715.35 Typical High $5,495.41 | Professional | None | $2,454.71 | $3,715.35 | $5,495.41 |
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 $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,071.52 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,819.70 | $1,819.70 |
Where Illinois sits
The same service costs 14.1 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
$2,951
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.