How much rates vary
Facilitymedian $1,862 · 10th to 90th $525 to $12,882Professionalmedian $1,202 · 10th to 90th $912 to $2,188
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 $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,918.31 Median $14,791.08 Typical High $29,512.09 | Facility | None | $6,918.31 | $14,791.08 | $29,512.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,698.24 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,630.78 | Professional | None | $954.99 | $1,479.11 | $3,630.78 |
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 $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,202.26 | $1,288.25 |
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 $977.24 Median $1,318.26 Typical High $2,089.30 | Professional | None | $977.24 | $1,318.26 | $2,089.30 |
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 $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $758.58 |
Where Illinois sits
The same service costs 11.9 times more in Maine than in Delaware. 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 $17,198DE $1,445
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.