How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $12,589Professionalmedian $1,820 · 10th to 90th $1,349 to $2,754
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 $1,023.29 Median $3,388.44 Typical High $9,772.37 | Facility | None | $1,023.29 | $3,388.44 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,348.96 | $2,089.30 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,772.37 Median $21,379.62 Typical High $42,657.95 | Facility | None | $9,772.37 | $21,379.62 | $42,657.95 |
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 $776.25 Typical High $2,511.89 | Facility | None | $512.86 | $776.25 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,548.82 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,495.41 | Professional | None | $1,348.96 | $2,137.96 | $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 $1,584.89 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 $3,019.95 | Professional | None | $1,380.38 | $1,862.09 | $3,019.95 |
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 $776.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,071.52 |
Where Illinois sits
The same service costs 13.9 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 $28,165MD $2,021
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.