How much rates vary
Facilitymedian $1,905 · 10th to 90th $537 to $8,913Professionalmedian $1,175 · 10th to 90th $871 to $1,778
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 $933.25 Median $2,951.21 Typical High $7,762.47 | Facility | None | $933.25 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,905.46 | Professional | None | $831.76 | $977.24 | $1,905.46 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,365.16 Median $9,332.54 Typical High $18,620.87 | Facility | None | $4,365.16 | $9,332.54 | $18,620.87 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,288.25 | Professional | None | $954.99 | $1,174.90 | $1,288.25 |
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 $870.96 Median $1,174.90 Typical High $1,584.89 | Professional | None | $870.96 | $1,174.90 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,818.38 | Professional | None | $794.33 | $1,258.93 | $2,818.38 |
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 $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | None | $870.96 | $1,023.29 | $1,148.15 |
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 $870.96 Median $1,258.93 Typical High $1,905.46 | Professional | None | $870.96 | $1,258.93 | $1,905.46 |
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 $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $691.83 |
Where Illinois sits
The same service costs 18.7 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 $26,826MD $1,433
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.