How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $12,882Professionalmedian $1,995 · 10th to 90th $1,514 to $3,020
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 $1,096.48 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,096.48 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,698.24 | $2,630.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,585.78 Median $16,218.10 Typical High $30,902.95 | Facility | None | $7,585.78 | $16,218.10 | $30,902.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,995.26 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,513.56 | $2,041.74 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $4,677.35 | Professional | None | $1,348.96 | $2,187.76 | $4,677.35 |
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 $1,479.11 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,778.28 | $1,995.26 |
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 $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,187.76 | $3,235.94 |
5 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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $169.82 |
Where Illinois sits
The same service costs 25.6 times more in Maine than in Maryland. 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.
Physician feeFacility fee
ME $53,236MD $2,076
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.