How much rates vary
Facilitymedian $1,622 · 10th to 90th $513 to $14,125Professionalmedian $1,820 · 10th to 90th $1,514 to $2,951
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 $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,659.59 | $1,659.59 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,511.38 Median $18,197.01 Typical High $37,153.52 | Facility | None | $8,511.38 | $18,197.01 | $37,153.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,238.72 | $2,951.21 |
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 $1,584.89 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,584.89 | $2,089.30 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,606.93 | Professional | None | $1,621.81 | $2,398.83 | $6,606.93 |
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 $1,778.28 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,995.26 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $154.88 | Professional | None | $33.11 | $33.11 | $154.88 |
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 $1,548.82 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,819.70 | $3,090.30 |
7 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 $758.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,174.90 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 51 · Multiple procedures | $707.95 | $707.95 | $707.95 |
Where Illinois sits
The same service costs 8.2 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 $17,891MD $2,184
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.