How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $14,125Professionalmedian $2,239 · 10th to 90th $1,660 to $3,236
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 $1,584.89 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,584.89 | $1,905.46 | $3,235.94 |
Ambetter Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,317.64 Median $17,782.79 Typical High $35,481.34 | Facility | None | $8,317.64 | $17,782.79 | $35,481.34 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,238.72 | $2,454.71 |
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 $1,659.59 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,238.72 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $5,248.07 | Professional | None | $1,513.56 | $2,398.83 | $5,248.07 |
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 $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
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 $1,659.59 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,398.83 | $3,630.78 |
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 $831.76 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $190.55 |
Where Illinois sits
The same service costs 24.1 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 $53,525MD $2,222
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.