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 $512.86 Median $1,862.09 Typical High $5,888.44 | Facility | None | $512.86 | $1,862.09 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $537.03 | Professional | None | $380.19 | $416.87 | $537.03 |
BCBS Illinois Setting Facility Modifier None Typical Low $2,238.72 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,238.72 | $4,786.30 | $9,549.93 |
BCBS Illinois Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $588.84 | Professional | None | $380.19 | $549.54 | $588.84 |
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 $389.05 Median $467.74 Typical High $562.34 | Professional | None | $389.05 | $467.74 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $1,513.56 | Professional | None | $346.74 | $537.03 | $1,513.56 |
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 $446.68 Median $457.09 Typical High $501.19 | Professional | None | $446.68 | $457.09 | $501.19 |
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 $346.74 Median $436.52 Typical High $831.76 | Professional | None | $346.74 | $436.52 | $831.76 |
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 $190.55 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $295.12 |
Where Illinois sits
The same service costs 6.9 times more in Alaska 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· 28th of 51
$479
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.