How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $10,233Professionalmedian $1,585 · 10th to 90th $1,047 to $2,570
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 $1,258.93 Median $5,370.32 Typical High $10,000.00 | Facility | None | $1,258.93 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,288.25 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $14,791.08 | Facility | None | $954.99 | $2,818.38 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,584.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,454.71 Typical High $3,801.89 | Professional | 50 · Both sides | $1,819.70 | $2,454.71 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,862.09 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,258.93 | $2,630.27 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,698.24 | $3,235.94 |
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 $630.96 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Where Georgia sits
The same service costs 18.2 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 $33,172MD $1,821
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.