How much rates vary
Facilitymedian $1,148 · 10th to 90th $447 to $7,762Professionalmedian $1,549 · 10th to 90th $1,259 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 $2,884.03 Typical High $9,549.93 | Facility | None | $1,023.29 | $2,884.03 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $2,511.89 | Facility | None | $501.19 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,479.11 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,288.25 | $2,041.74 | $4,897.79 |
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 $1,513.56 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,621.81 | $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 $416.87 Median $891.25 Typical High $3,019.95 | Facility | None | $416.87 | $891.25 | $3,019.95 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,778.28 | $2,818.38 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,023.29 |
Where Illinois sits
The same service costs 13.1 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 $24,687MD $1,882
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.