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 $724.44 Median $2,754.23 Typical High $7,762.47 | Facility | None | $724.44 | $2,754.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $2,041.74 Typical High $2,398.83 | Professional | None | $436.52 | $2,041.74 | $2,398.83 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,011.87 Median $6,025.60 Typical High $8,128.31 | Facility | None | $5,011.87 | $6,025.60 | $8,128.31 |
BCBS Illinois Setting Professional Modifier None Typical Low $457.09 Median $1,819.70 Typical High $3,467.37 | Professional | None | $457.09 | $1,819.70 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,309.57 Typical High $7,943.28 | Facility | None | $776.25 | $6,309.57 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $1,737.80 Typical High $3,311.31 | Professional | None | $467.74 | $1,737.80 | $3,311.31 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $2,398.83 Typical High $11,481.54 | Professional | None | $467.74 | $2,398.83 | $11,481.54 |
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 $524.81 Median $537.03 Typical High $2,630.27 | Professional | None | $524.81 | $537.03 | $2,630.27 |
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 $1,288.25 Median $4,073.80 Typical High $10,715.19 | Facility | None | $1,288.25 | $4,073.80 | $10,715.19 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,819.70 Typical High $4,570.88 | Professional | None | $446.68 | $1,819.70 | $4,570.88 |
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 $218.78 Median $537.03 Typical High $1,202.26 | Professional | 52 · Reduced service | $218.78 | $537.03 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $213.80 Typical High $478.63 | Professional | 53 · Discontinued | $87.10 | $213.80 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $794.33 Typical High $1,778.28 | Professional | 54 · Surgery only | $331.13 | $794.33 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $158.49 Typical High $354.81 | Professional | 55 · Aftercare only | $66.07 | $158.49 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $107.15 Typical High $239.88 | Professional | 56 · Pre-op care only | $43.65 | $107.15 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $741.31 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $309.03 | $741.31 | $1,659.59 |
Where Illinois sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 21st of 51
$2,188
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.