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 $4,466.84 Typical High $9,772.37 | Facility | None | $933.25 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $5,128.61 | Professional | None | $3,630.78 | $4,466.84 | $5,128.61 |
BCBS Illinois Setting Facility Modifier None Typical Low $26,302.68 Median $56,234.13 Typical High $112,201.85 | Facility | None | $26,302.68 | $56,234.13 | $112,201.85 |
BCBS Illinois Setting Professional Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $7,943.28 | Professional | None | $5,623.41 | $7,079.46 | $7,943.28 |
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 $3,801.89 Median $5,888.44 Typical High $8,511.38 | Professional | None | $3,801.89 | $5,888.44 | $8,511.38 |
Hally Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,606.93 Typical High $13,489.63 | Professional | None | $4,073.80 | $6,606.93 | $13,489.63 |
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 $4,365.16 Median $5,370.32 Typical High $6,309.57 | Professional | None | $4,365.16 | $5,370.32 | $6,309.57 |
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 $4,073.80 Median $6,309.57 Typical High $9,549.93 | Professional | None | $4,073.80 | $6,309.57 | $9,549.93 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,819.70 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,691.53 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,090.30 | $3,090.30 |
Where Illinois sits
The same service costs 21.4 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· 18th of 51
$5,623
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.