How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $10,233Professionalmedian $1,122 · 10th to 90th $955 to $1,905
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 $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $11,748.98 Typical High $23,442.29 | Facility | None | $5,495.41 | $11,748.98 | $23,442.29 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,479.11 | $1,949.84 |
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 $977.24 Median $1,318.26 Typical High $1,905.46 | Professional | None | $977.24 | $1,318.26 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,023.29 | $1,548.82 | $3,548.13 |
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 $1,148.15 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,288.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $144.54 | Professional | None | $33.11 | $33.11 | $144.54 |
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 $977.24 Median $1,174.90 Typical High $1,995.26 | Professional | None | $977.24 | $1,174.90 | $1,995.26 |
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 $489.78 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $758.58 |
Where Illinois sits
The same service costs 10.6 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 $17,137MD $1,609
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.