How much rates vary
Facilitymedian $2,884 · 10th to 90th $891 to $11,220Professionalmedian $1,514 · 10th to 90th $1,122 to $2,239
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 $954.99 Median $1,479.11 Typical High $7,762.47 | Facility | None | $954.99 | $1,479.11 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,148.15 | $1,737.80 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $30,199.52 | Facility | None | $7,079.46 | $15,135.61 | $30,199.52 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,778.28 | $2,041.74 |
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 $1,174.90 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,318.26 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $4,265.80 | Professional | None | $1,148.15 | $1,862.09 | $4,265.80 |
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 $1,348.96 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,479.11 | $1,621.81 |
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 $1,174.90 Median $3,090.30 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,090.30 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,548.82 | $2,570.40 |
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 $501.19 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $831.76 |
Where Illinois sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.