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 $426.58 Median $1,737.80 Typical High $5,623.41 | Facility | None | $426.58 | $1,737.80 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $676.08 | Professional | None | $346.74 | $398.11 | $676.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $4,466.84 | Facility | None | $457.09 | $691.83 | $4,466.84 |
BCBS Illinois Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $707.95 | Professional | None | $363.08 | $524.81 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $812.83 | Facility | None | $426.58 | $575.44 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $630.96 | Professional | None | $323.59 | $436.52 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $1,258.93 | Professional | None | $323.59 | $512.86 | $1,258.93 |
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 $416.87 Median $426.58 Typical High $501.19 | Professional | None | $416.87 | $426.58 | $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 $446.68 Median $1,047.13 Typical High $3,019.95 | Facility | None | $446.68 | $1,047.13 | $3,019.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $812.83 | Professional | None | $338.84 | $436.52 | $812.83 |
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 $173.78 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $302.00 |
Where Illinois sits
The same service costs 5.6 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· 24th of 51
$468
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.