How much rates vary
Facilitymedian $1,738 · 10th to 90th $525 to $15,136Professionalmedian $2,291 · 10th to 90th $1,660 to $3,631
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 $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,949.84 | $1,949.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $11,748.98 Median $25,118.86 Typical High $50,118.72 | Facility | None | $11,748.98 | $25,118.86 | $50,118.72 |
BCBS Illinois Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,454.71 | $3,090.30 | $3,548.13 |
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 $2,511.89 Typical High $3,630.78 | Professional | None | $1,949.84 | $2,511.89 | $3,630.78 |
Hally Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $6,918.31 | Professional | None | $2,041.74 | $3,019.95 | $6,918.31 |
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 $2,041.74 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,398.83 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,511.89 | Professional | None | $33.11 | $33.11 | $2,511.89 |
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 $1,778.28 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,187.76 | $3,890.45 |
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 $812.83 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,380.38 |
Where Illinois sits
The same service costs 14.4 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 $34,547MD $2,395
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.