How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $12,589Professionalmedian $1,820 · 10th to 90th $1,380 to $2,951
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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,584.89 | $1,995.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $30,199.52 | Facility | None | $7,079.46 | $15,135.61 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,905.46 | $2,137.96 |
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 $1,412.54 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,548.82 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,258.93 | $1,995.26 | $4,466.84 |
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 $1,380.38 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,659.59 | $1,862.09 |
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 $1,348.96 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,348.96 | $2,041.74 | $3,019.95 |
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 $707.95 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,122.02 |
Where Illinois sits
The same service costs 8.1 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 $15,945MD $1,975
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.