How much rates vary
Facilitymedian $1,622 · 10th to 90th $513 to $14,454Professionalmedian $1,950 · 10th to 90th $1,514 to $3,020
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 $1,548.82 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,698.24 | $2,630.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,709.64 Median $18,620.87 Typical High $37,153.52 | Facility | None | $8,709.64 | $18,620.87 | $37,153.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,290.87 | $3,019.95 |
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 $1,548.82 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,548.82 | $2,041.74 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $5,248.07 | Professional | None | $1,621.81 | $2,454.71 | $5,248.07 |
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 $1,819.70 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,819.70 | $2,041.74 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $218.78 | Professional | None | $33.11 | $33.11 | $218.78 |
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 $1,584.89 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,862.09 | $3,162.28 |
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 $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,202.26 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 22 · Increased work | $1,479.11 | $1,479.11 | $1,479.11 |
Where Illinois sits
The same service costs 8.1 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 $2,222
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.