How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $12,589Professionalmedian $1,549 · 10th to 90th $1,096 to $2,399
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 $1,047.13 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,174.90 | $1,258.93 |
BCBS Illinois Setting Facility Modifier None Typical Low $7,244.36 Median $15,488.17 Typical High $30,902.95 | Facility | None | $7,244.36 | $15,488.17 | $30,902.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,479.11 | $2,041.74 | $2,290.87 |
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 $1,230.27 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,584.89 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $4,897.79 | Professional | None | $1,122.02 | $1,778.28 | $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 $1,258.93 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,445.44 | $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 $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 $1,148.15 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,513.56 | $2,511.89 |
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 $524.81 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $812.83 |
Where Illinois sits
The same service costs 15.4 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 $28,500MD $1,851
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.