How much rates vary
Facilitymedian $1,995 · 10th to 90th $537 to $13,490Professionalmedian $1,479 · 10th to 90th $1,047 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 $1,047.13 Median $3,801.89 Typical High $14,125.38 | Facility | None | $1,047.13 | $3,801.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,122.02 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,760.83 Median $14,454.40 Typical High $29,512.09 | Facility | None | $6,760.83 | $14,454.40 | $29,512.09 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,905.46 | $2,137.96 |
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 $1,122.02 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,445.44 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,466.84 | Professional | None | $1,071.52 | $1,698.24 | $4,466.84 |
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 $1,230.27 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,380.38 | $1,548.82 |
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 $1,047.13 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,380.38 | $2,398.83 |
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 $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $776.25 |
Where Illinois sits
The same service costs 16.4 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 $28,429MD $1,737
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.