How much rates vary
Facilitymedian $1,413 · 10th to 90th $490 to $6,607Professionalmedian $372 · 10th to 90th $257 to $562
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 $281.84 Median $1,621.81 Typical High $7,762.47 | Facility | None | $281.84 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $363.08 | Professional | None | $245.47 | $281.84 | $363.08 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,584.89 | $3,388.44 | $6,760.83 |
BCBS Illinois Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $537.03 | Professional | None | $331.13 | $416.87 | $537.03 |
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 $295.12 Median $371.54 Typical High $524.81 | Professional | None | $295.12 | $371.54 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $1,380.38 | Professional | None | $263.03 | $426.58 | $1,380.38 |
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 $295.12 Median $346.74 Typical High $389.05 | Professional | None | $295.12 | $346.74 | $389.05 |
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 $245.47 Median $354.81 Typical High $602.56 | Professional | None | $245.47 | $354.81 | $602.56 |
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 $123.03 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $28.18 |
Where Illinois sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.