How much rates vary
Facilitymedian $1,778 · 10th to 90th $525 to $15,136Professionalmedian $2,951 · 10th to 90th $2,138 to $4,467
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 $1,023.29 Median $3,235.94 Typical High $7,762.47 | Facility | None | $1,023.29 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,949.84 | $2,454.71 | $2,454.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $14,454.40 Median $30,902.95 Typical High $63,095.73 | Facility | None | $14,454.40 | $30,902.95 | $63,095.73 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $4,365.16 | Professional | None | $3,090.30 | $3,890.45 | $4,365.16 |
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 $2,454.71 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,090.30 | $4,466.84 |
Hally Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $8,128.31 | Professional | None | $2,570.40 | $3,890.45 | $8,128.31 |
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 $2,570.40 Median $3,019.95 Typical High $3,467.37 | Professional | None | $2,570.40 | $3,019.95 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $3,162.28 | Professional | None | $33.11 | $33.11 | $3,162.28 |
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 $2,187.76 Median $2,630.27 Typical High $4,786.30 | Professional | None | $2,187.76 | $2,630.27 | $4,786.30 |
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 $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,513.56 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,698.24 | $1,698.24 |
Where Illinois sits
The same service costs 13.8 times more in Maine than in Texas. 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 $35,114TX $2,545
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.