How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $13,183Professionalmedian $1,698 · 10th to 90th $1,175 to $2,884
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 $1,096.48 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,348.96 | $1,584.89 |
BCBS Illinois Setting Facility Modifier None Typical Low $8,128.31 Median $17,378.01 Typical High $34,673.69 | Facility | None | $8,128.31 | $17,378.01 | $34,673.69 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,238.72 | $3,801.89 |
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 $1,318.26 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,819.70 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,258.93 | $2,041.74 | $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 $1,380.38 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,659.59 | $1,905.46 |
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 $1,288.25 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,905.46 | $2,884.03 |
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 $549.54 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $954.99 |
Where Illinois sits
The same service costs 8.5 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 $16,489MD $1,943
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.