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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,905.46 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,220.18 Median $23,988.33 Typical High $47,863.01 | Facility | None | $11,220.18 | $23,988.33 | $47,863.01 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,548.82 Typical High $3,235.94 | Facility | None | $524.81 | $1,548.82 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,737.80 | $2,454.71 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $6,606.93 | Professional | None | $1,905.46 | $2,884.03 | $6,606.93 |
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 $1,905.46 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,290.87 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,511.89 | Professional | None | $33.11 | $33.11 | $2,511.89 |
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 $1,659.59 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,041.74 | $3,548.13 |
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 $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,318.26 | $1,318.26 |
Where Illinois sits
The same service costs 6.0 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· 35th of 51
$1,995
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.