How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $10,000Professionalmedian $1,148 · 10th to 90th $851 to $1,738
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 $794.33 Median $1,905.46 Typical High $7,762.47 | Facility | None | $794.33 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,122.02 | Professional | None | $794.33 | $977.24 | $1,122.02 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,248.07 Median $11,220.18 Typical High $22,387.21 | Facility | None | $5,248.07 | $11,220.18 | $22,387.21 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,380.38 | $1,621.81 |
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 $933.25 Median $1,122.02 Typical High $1,698.24 | Professional | None | $933.25 | $1,122.02 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $3,548.13 | Professional | None | $851.14 | $1,348.96 | $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 $977.24 Median $1,096.48 Typical High $1,230.27 | Professional | None | $977.24 | $1,096.48 | $1,230.27 |
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 $812.83 Median $1,122.02 Typical High $1,995.26 | Professional | None | $812.83 | $1,122.02 | $1,995.26 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $676.08 | $676.08 |
Where Illinois sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.