How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $15,136Professionalmedian $1,514 · 10th to 90th $1,259 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 $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 $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
BCBS Illinois Setting Facility Modifier None Typical Low $9,332.54 Median $19,952.62 Typical High $39,810.72 | Facility | None | $9,332.54 | $19,952.62 | $39,810.72 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,513.56 | $2,238.72 | $2,398.83 |
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 $1,258.93 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,445.44 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $4,677.35 | Professional | None | $1,288.25 | $1,995.26 | $4,677.35 |
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 $1,479.11 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,584.89 | $1,737.80 |
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 $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
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 $630.96 Median $630.96 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,000.00 |
Where Illinois sits
The same service costs 9.0 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 $17,266MD $1,911
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.