How much rates vary
Facilitymedian $1,738 · 10th to 90th $513 to $15,136Professionalmedian $2,042 · 10th to 90th $1,445 to $3,311
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 $1,023.29 Median $1,905.46 Typical High $7,762.47 | Facility | None | $1,023.29 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,862.09 | $1,862.09 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,549.93 Median $20,417.38 Typical High $41,686.94 | Facility | None | $9,549.93 | $20,417.38 | $41,686.94 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,511.89 | $3,162.28 |
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 $1,445.44 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,290.87 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $6,456.54 | Professional | None | $1,737.80 | $2,691.53 | $6,456.54 |
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 $1,995.26 Median $2,290.87 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,290.87 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
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 $1,698.24 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,041.74 | $3,548.13 |
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 $870.96 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $870.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,318.26 |
Where Illinois sits
The same service costs 7.6 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 $18,140MD $2,382
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.