How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $10,965Professionalmedian $1,023 · 10th to 90th $741 to $1,622
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 $794.33 Median $1,905.46 Typical High $7,762.47 | Facility | None | $794.33 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $954.99 | Professional | None | $776.25 | $812.83 | $954.99 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,888.44 Median $12,589.25 Typical High $25,118.86 | Facility | None | $5,888.44 | $12,589.25 | $25,118.86 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,513.56 | $1,548.82 |
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 $741.31 Median $933.25 Typical High $1,479.11 | Professional | None | $741.31 | $933.25 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $3,311.31 | Professional | None | $758.58 | $1,174.90 | $3,311.31 |
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 $977.24 Typical High $1,096.48 | Professional | None | $870.96 | $977.24 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $1,023.29 Typical High $1,778.28 | Professional | None | $758.58 | $1,023.29 | $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 $398.11 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $602.56 |
Where Illinois sits
The same service costs 16.9 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 $23,956MD $1,413
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.