How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $10,965Professionalmedian $1,288 · 10th to 90th $871 to $2,042
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 $1,905.46 Typical High $7,762.47 | Facility | None | $812.83 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,148.15 | Professional | None | $812.83 | $977.24 | $1,148.15 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,888.44 Median $12,589.25 Typical High $25,118.86 | Facility | None | $5,888.44 | $12,589.25 | $25,118.86 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,621.81 | $1,862.09 |
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 $870.96 Median $1,288.25 Typical High $1,949.84 | Professional | None | $870.96 | $1,288.25 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $4,677.35 | Professional | None | $933.25 | $1,479.11 | $4,677.35 |
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 $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
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 $933.25 Median $1,380.38 Typical High $2,089.30 | Professional | None | $933.25 | $1,380.38 | $2,089.30 |
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 $407.38 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $691.83 | $691.83 |
Where Illinois sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $16,050AR $1,584
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.