How much rates vary
Facilitymedian $1,698 · 10th to 90th $513 to $15,136Professionalmedian $2,692 · 10th to 90th $1,820 to $4,169
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 $2,041.74 Typical High $7,762.47 | Facility | None | $933.25 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,698.24 | $2,041.74 | $2,344.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $12,302.69 Median $26,302.68 Typical High $52,480.75 | Facility | None | $12,302.69 | $26,302.68 | $52,480.75 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,311.31 | $3,715.35 |
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 $1,949.84 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,754.23 | $3,981.07 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $7,413.10 | Professional | None | $1,905.46 | $3,090.30 | $7,413.10 |
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 $2,089.30 Median $2,511.89 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,511.89 | $2,884.03 |
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 $1,949.84 Median $2,884.03 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,884.03 | $4,365.16 |
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 $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,445.44 | $1,445.44 |
Where Illinois sits
The same service costs 13.4 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 $34,930MD $2,604
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.