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 $537.03 Median $1,348.96 Typical High $5,623.41 | Facility | None | $537.03 | $1,348.96 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $977.24 | Professional | None | $512.86 | $588.84 | $977.24 |
BCBS Illinois Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $6,309.57 | Facility | None | $457.09 | $691.83 | $6,309.57 |
BCBS Illinois Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $954.99 | Professional | None | $512.86 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $562.34 Typical High $794.33 | Facility | None | $416.87 | $562.34 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,202.26 | Professional | None | $549.54 | $851.14 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $2,137.96 | Professional | None | $478.63 | $776.25 | $2,137.96 |
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 $588.84 Median $602.56 Typical High $691.83 | Professional | None | $588.84 | $602.56 | $691.83 |
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 $524.81 Median $912.01 Typical High $1,348.96 | Professional | None | $524.81 | $912.01 | $1,348.96 |
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 $245.47 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $407.38 |
Where Illinois sits
The same service costs 6.2 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· 26th of 51
$741
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.