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 $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,174.90 | Professional | None | $851.14 | $954.99 | $1,174.90 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $10,715.19 | Facility | None | $2,630.27 | $4,168.69 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $3,890.45 | Facility | None | $741.31 | $3,090.30 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,318.26 | Professional | None | $776.25 | $933.25 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,951.21 | Professional | None | $758.58 | $1,174.90 | $2,951.21 |
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 $1,000.00 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,023.29 | $1,096.48 |
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 $1,174.90 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,174.90 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,698.24 | Professional | None | $691.83 | $912.01 | $1,698.24 |
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 $426.58 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $660.69 |
Where Illinois sits
The same service costs 8.3 times more in Wyoming than in Utah. 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· 27th of 51
$1,047
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.