How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $9,550Professionalmedian $1,023 · 10th to 90th $851 to $1,698
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 $891.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $891.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | None | $870.96 | $954.99 | $954.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,897.79 Median $10,471.29 Typical High $20,892.96 | Facility | None | $4,897.79 | $10,471.29 | $20,892.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,288.25 | $1,737.80 |
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 $891.25 Median $1,148.15 Typical High $1,659.59 | Professional | None | $891.25 | $1,148.15 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $3,388.44 | Professional | None | $933.25 | $1,348.96 | $3,388.44 |
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 $1,023.29 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,148.15 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | None | $33.11 | $33.11 | $123.03 |
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 $870.96 Median $1,047.13 Typical High $1,778.28 | Professional | None | $870.96 | $1,047.13 | $1,778.28 |
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 $436.52 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Where Illinois sits
The same service costs 11.4 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 $16,997MD $1,496
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.