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 $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $16,595.87 | Facility | None | $1,445.44 | $2,290.87 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,737.80 Typical High $2,238.72 | Facility | None | $776.25 | $1,737.80 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,621.81 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,174.90 | $1,995.26 | $3,715.35 |
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 $1,318.26 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,584.89 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,862.09 | Professional | None | $33.11 | $33.11 | $1,862.09 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $4,365.16 | Facility | None | $676.08 | $1,513.56 | $4,365.16 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,454.71 | Professional | None | $891.25 | $1,230.27 | $2,454.71 |
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 $512.86 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $208.93 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $912.01 | $912.01 |
Where Illinois sits
The same service costs 5.8 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· 32nd of 51
$1,318
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.