How much rates vary
Facilitymedian $1,738 · 10th to 90th $513 to $15,136Professionalmedian $2,291 · 10th to 90th $1,950 to $3,802
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 $2,137.96 Typical High $7,762.47 | Facility | None | $933.25 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,949.84 | $2,137.96 | $2,137.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,964.78 Median $23,442.29 Typical High $47,863.01 | Facility | None | $10,964.78 | $23,442.29 | $47,863.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,454.71 | $2,884.03 | $3,801.89 |
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 $2,041.74 Median $2,630.27 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,630.27 | $3,715.35 |
Hally Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $8,317.64 | Professional | None | $2,089.30 | $3,019.95 | $8,317.64 |
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 $2,238.72 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,570.40 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $199.53 | Professional | None | $33.11 | $33.11 | $199.53 |
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 $1,995.26 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,344.23 | $3,981.07 |
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 $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,479.11 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,513.56 | $1,513.56 |
Where Illinois sits
The same service costs 6.9 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 $18,419MD $2,652
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.