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 $2,089.30 Typical High $7,762.47 | Facility | None | $933.25 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,089.30 | $3,311.31 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,302.69 Median $26,302.68 Typical High $52,480.75 | Facility | None | $12,302.69 | $26,302.68 | $52,480.75 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,388.44 | $3,801.89 |
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 $1,862.09 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,754.23 | $4,073.80 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $7,244.36 | Professional | None | $1,905.46 | $3,090.30 | $7,244.36 |
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 $2,089.30 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,511.89 | $2,951.21 |
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 $1,862.09 Median $2,818.38 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,818.38 | $4,365.16 |
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 $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,445.44 | $1,445.44 |
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
$2,512
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.