How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $11,749Professionalmedian $1,413 · 10th to 90th $955 to $2,291
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 $870.96 Median $1,905.46 Typical High $7,762.47 | Facility | None | $870.96 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,309.57 Median $13,489.63 Typical High $26,915.35 | Facility | None | $6,309.57 | $13,489.63 | $26,915.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
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 $1,071.52 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,445.44 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $3,981.07 | Professional | None | $1,000.00 | $1,621.81 | $3,981.07 |
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 $1,096.48 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,288.25 | $1,479.11 |
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 $1,023.29 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,548.82 | $2,290.87 |
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 $436.52 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
Where Illinois sits
The same service costs 9.8 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 $16,204MD $1,659
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.