How much rates vary
Facilitymedian $1,778 · 10th to 90th $525 to $12,589Professionalmedian $1,549 · 10th to 90th $1,096 to $2,239
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 $831.76 Median $2,137.96 Typical High $7,762.47 | Facility | None | $831.76 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,230.27 | $1,949.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,128.31 Median $17,378.01 Typical High $34,673.69 | Facility | None | $8,128.31 | $17,378.01 | $34,673.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,230.27 | $2,089.30 | $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 $1,071.52 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,445.44 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $3,548.13 | Professional | None | $977.24 | $1,621.81 | $3,548.13 |
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 $1,071.52 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,258.93 | $1,412.54 |
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 $1,096.48 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,621.81 | $2,344.23 |
4 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 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $851.14 |
Where Illinois sits
The same service costs 9.4 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 $15,900MD $1,684
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.