How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $11,749Professionalmedian $1,622 · 10th to 90th $1,175 to $2,512
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 $2,754.23 Typical High $9,120.11 | Facility | None | $1,148.15 | $2,754.23 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,230.27 | $2,137.96 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,912.51 Median $19,054.61 Typical High $38,018.94 | Facility | None | $8,912.51 | $19,054.61 | $38,018.94 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,290.87 | Professional | None | $1,445.44 | $2,187.76 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,380.38 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $4,786.30 | Professional | None | $1,230.27 | $1,862.09 | $4,786.30 |
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 $1,412.54 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,513.56 | $1,659.59 |
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 $1,230.27 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,659.59 | $2,691.53 |
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 $616.60 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $954.99 |
Where Illinois sits
The same service costs 14.8 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 $28,001MD $1,894
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.