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 $831.76 Median $2,238.72 Typical High $7,762.47 | Facility | None | $831.76 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,445.44 | $1,445.44 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $18,197.01 | Facility | None | $6,309.57 | $9,332.54 | $18,197.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,659.59 | $2,137.96 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $7,244.36 Typical High $9,332.54 | Facility | None | $741.31 | $7,244.36 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,698.24 | $2,511.89 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,548.82 | $2,290.87 | $5,128.61 |
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 $1,659.59 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,819.70 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,778.28 | Professional | None | $33.11 | $33.11 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,778.28 | $2,951.21 |
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 $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,023.29 |
Where Illinois sits
The same service costs 24.5 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· 31st of 51
$1,820
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.