How much rates vary
Facilitymedian $3,090 · 10th to 90th $832 to $9,772Professionalmedian $1,047 · 10th to 90th $724 to $1,585
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 $812.83 Median $3,235.94 Typical High $9,332.54 | Facility | None | $812.83 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,380.38 | Professional | None | $691.83 | $812.83 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,897.79 Median $10,471.29 Typical High $20,892.96 | Facility | None | $4,897.79 | $10,471.29 | $20,892.96 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,318.26 | $1,479.11 |
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 $724.44 Median $933.25 Typical High $1,479.11 | Professional | None | $724.44 | $933.25 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,691.53 | Professional | None | $794.33 | $1,258.93 | $2,691.53 |
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 $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $933.25 | $1,023.29 | $1,122.02 |
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 $776.25 Median $1,023.29 Typical High $1,737.80 | Professional | None | $776.25 | $1,023.29 | $1,737.80 |
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 $346.74 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $562.34 |
Where Illinois sits
The same service costs 11.6 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 $23,484TX $2,029
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.