How much rates vary
Facilitymedian $1,622 · 10th to 90th $513 to $12,589Professionalmedian $1,950 · 10th to 90th $1,445 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 $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 $1,479.11 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,698.24 | $2,041.74 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,413.10 Median $15,848.93 Typical High $32,359.37 | Facility | None | $7,413.10 | $15,848.93 | $32,359.37 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,995.26 | $2,187.76 |
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 $1,479.11 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,995.26 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $4,786.30 | Professional | None | $1,318.26 | $2,089.30 | $4,786.30 |
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 $1,445.44 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,737.80 | $1,949.84 |
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 $2,137.96 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,137.96 | $3,235.94 |
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 $741.31 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 7.5 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 $16,075MD $2,147
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.