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 $2,398.83 Typical High $7,762.47 | Facility | None | $933.25 | $2,398.83 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,398.83 | $2,754.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,125.38 Median $30,199.52 Typical High $60,255.96 | Facility | None | $14,125.38 | $30,199.52 | $60,255.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $6,760.83 | Professional | None | $3,090.30 | $3,801.89 | $6,760.83 |
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 $2,238.72 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,238.72 | $3,162.28 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $8,709.64 | Professional | None | $2,187.76 | $3,548.13 | $8,709.64 |
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 $2,344.23 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,884.03 | $3,311.31 |
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 $2,238.72 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,238.72 | $3,388.44 | $5,011.87 |
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 $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $977.24 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,659.59 | $1,659.59 |
Where Illinois sits
The same service costs 12.0 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· 26th of 51
$2,754
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.