How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $8,710Professionalmedian $871 · 10th to 90th $741 to $1,479
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 $776.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $776.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,265.80 Median $9,120.11 Typical High $18,197.01 | Facility | None | $4,265.80 | $9,120.11 | $18,197.01 |
BCBS Illinois Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,513.56 | Professional | None | $954.99 | $1,122.02 | $1,513.56 |
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 $812.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $812.83 | $1,071.52 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $3,162.28 | Professional | None | $812.83 | $1,174.90 | $3,162.28 |
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 $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | None | $870.96 | $1,000.00 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $77.62 | Professional | None | $33.11 | $33.11 | $77.62 |
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 $758.58 Median $891.25 Typical High $1,548.82 | Professional | None | $758.58 | $891.25 | $1,548.82 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $575.44 |
Where Illinois sits
The same service costs 12.3 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 $16,849MD $1,375
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.