How much rates vary
Facilitymedian $1,738 · 10th to 90th $513 to $15,136Professionalmedian $2,455 · 10th to 90th $2,042 to $4,169
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 $2,344.23 Typical High $7,762.47 | Facility | None | $933.25 | $2,344.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,344.23 | $2,344.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,022.64 Median $25,703.96 Typical High $51,286.14 | Facility | None | $12,022.64 | $25,703.96 | $51,286.14 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,890.45 | Professional | None | $2,630.27 | $3,090.30 | $3,890.45 |
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 $2,137.96 Median $2,818.38 Typical High $4,073.80 | Professional | None | $2,137.96 | $2,818.38 | $4,073.80 |
Hally Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $8,912.51 | Professional | None | $2,187.76 | $3,235.94 | $8,912.51 |
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 $2,398.83 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,818.38 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $295.12 | Professional | None | $33.11 | $33.11 | $295.12 |
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 $2,089.30 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,511.89 | $4,365.16 |
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 $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,621.81 |
Where Illinois sits
The same service costs 7.6 times more in Maine than in Texas. 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 $18,667TX $2,469
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.