How much rates vary
Facilitymedian $1,778 · 10th to 90th $525 to $12,303Professionalmedian $1,820 · 10th to 90th $1,349 to $2,692
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 $1,148.15 Median $1,995.26 Typical High $7,079.46 | Facility | None | $1,148.15 | $1,995.26 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,348.96 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $1,230.27 Typical High $1,737.80 | Professional | None | $234.42 | $1,230.27 | $1,737.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,772.37 Median $20,892.96 Typical High $41,686.94 | Facility | None | $9,772.37 | $20,892.96 | $41,686.94 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $2,570.40 | Professional | None | $1,584.89 | $2,398.83 | $2,570.40 |
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 $1,380.38 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,513.56 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $5,754.40 | Professional | None | $1,348.96 | $2,089.30 | $5,754.40 |
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 $1,584.89 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,698.24 | $1,819.70 |
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 $1,380.38 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,862.09 | $2,951.21 |
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 $676.08 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,071.52 |
Where Illinois sits
The same service costs 14.0 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 $28,122MD $2,008
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.