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 $416.87 Median $1,698.24 Typical High $5,623.41 | Facility | None | $416.87 | $1,698.24 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $616.60 | Professional | None | $239.88 | $363.08 | $616.60 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $4,168.69 | Facility | None | $371.54 | $602.56 | $4,168.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $660.69 | Professional | None | $239.88 | $407.38 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $1,096.48 | Facility | None | $346.74 | $501.19 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $724.44 | Professional | None | $275.42 | $380.19 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $1,000.00 | Professional | None | $263.03 | $478.63 | $1,000.00 |
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 $281.84 Median $288.40 Typical High $478.63 | Professional | None | $281.84 | $288.40 | $478.63 |
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 $1,047.13 Median $2,454.71 Typical High $6,165.95 | Facility | None | $1,047.13 | $2,454.71 | $6,165.95 |
United Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $758.58 | Professional | None | $251.19 | $389.05 | $758.58 |
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 $117.49 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $117.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $177.83 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $35.48 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $165.96 | $251.19 | $288.40 |
Where Illinois sits
The same service costs 3.9 times more in Wyoming 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· 22nd of 51
$417
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.