How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $15,136Professionalmedian $1,738 · 10th to 90th $1,288 to $2,570
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 $1,288.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,288.25 | $1,995.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,549.93 Median $20,417.38 Typical High $40,738.03 | Facility | None | $9,549.93 | $20,417.38 | $40,738.03 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,344.23 | $2,454.71 |
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 $1,318.26 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,479.11 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $5,495.41 | Professional | None | $1,288.25 | $1,995.26 | $5,495.41 |
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 $1,513.56 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,621.81 | $1,778.28 |
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 $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,778.28 | $2,884.03 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,023.29 |
Where Illinois sits
The same service costs 12.5 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 $24,646MD $1,975
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.