How much rates vary
Facilitymedian $1,622 · 10th to 90th $513 to $15,136Professionalmedian $2,291 · 10th to 90th $1,479 to $3,388
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 $1,380.38 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,659.59 | $2,630.27 |
BCBS Illinois Setting Facility Modifier None Typical Low $10,000.00 Median $21,379.62 Typical High $42,657.95 | Facility | None | $10,000.00 | $21,379.62 | $42,657.95 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,691.53 | $3,019.95 |
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 $1,479.11 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,187.76 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $6,309.57 | Professional | None | $1,479.11 | $2,570.40 | $6,309.57 |
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 $1,698.24 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,698.24 | $2,041.74 | $2,344.23 |
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 $1,584.89 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,344.23 | $3,548.13 |
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 $691.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,174.90 | $1,174.90 |
Where Illinois sits
The same service costs 15.5 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 $34,449MD $2,222
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.