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 $2,754.23 Typical High $7,762.47 | Facility | None | $933.25 | $2,754.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,754.23 | $2,754.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $16,595.87 Median $35,481.34 Typical High $70,794.58 | Facility | None | $16,595.87 | $35,481.34 | $70,794.58 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,467.37 Median $4,466.84 Typical High $5,011.87 | Professional | None | $3,467.37 | $4,466.84 | $5,011.87 |
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 $2,630.27 Median $3,630.78 Typical High $5,370.32 | Professional | None | $2,630.27 | $3,630.78 | $5,370.32 |
Hally Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,168.69 Typical High $8,511.38 | Professional | None | $2,511.89 | $4,168.69 | $8,511.38 |
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 $2,754.23 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,388.44 | $3,890.45 |
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 $2,511.89 Median $3,801.89 Typical High $5,888.44 | Professional | None | $2,511.89 | $3,801.89 | $5,888.44 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,122.02 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,949.84 | $1,949.84 |
Where Illinois sits
The same service costs 10.0 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· 20th of 51
$3,467
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.