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 $239.88 Median $1,318.26 Typical High $5,623.41 | Facility | None | $239.88 | $1,318.26 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $223.87 Typical High $269.15 | Professional | None | $97.72 | $223.87 | $269.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $1,737.80 | Facility | None | $309.03 | $478.63 | $1,737.80 |
BCBS Illinois Setting Professional Modifier None Typical Low $102.33 Median $251.19 Typical High $398.11 | Professional | None | $102.33 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $549.54 | Facility | None | $288.40 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $218.78 Typical High $436.52 | Professional | None | $75.86 | $218.78 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $275.42 Typical High $724.44 | Professional | None | $100.00 | $275.42 | $724.44 |
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 $117.49 Median $117.49 Typical High $302.00 | Professional | None | $117.49 | $117.49 | $302.00 |
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 $676.08 Median $1,513.56 Typical High $4,073.80 | Facility | None | $676.08 | $1,513.56 | $4,073.80 |
United Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $446.68 | Professional | None | $100.00 | $213.80 | $446.68 |
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 $48.98 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $48.98 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $19.50 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $72.44 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $14.45 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.77 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $67.61 | $158.49 | $190.55 |
Where Illinois sits
The same service costs 5.6 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· 16th of 51
$251
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.