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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,862.09 | $2,884.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,964.78 Median $23,442.29 Typical High $47,863.01 | Facility | None | $10,964.78 | $23,442.29 | $47,863.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,019.95 | $3,388.44 |
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 $1,819.70 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,819.70 | $2,454.71 | $3,630.78 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $6,025.60 | Professional | None | $1,737.80 | $2,754.23 | $6,025.60 |
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 $1,862.09 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,238.72 | $2,630.27 |
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 $1,737.80 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,630.27 | $3,981.07 |
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 $758.58 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,288.25 |
Where Illinois sits
The same service costs 5.9 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· 21st of 51
$2,291
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.