How much rates vary
Facilitymedian $1,738 · 10th to 90th $468 to $13,183Professionalmedian $1,202 · 10th to 90th $955 to $1,862
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 $794.33 Median $1,122.02 Typical High $2,630.27 | Facility | None | $794.33 | $1,122.02 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,122.02 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $10,715.19 Typical High $19,054.61 | Facility | None | $6,165.95 | $10,715.19 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,659.59 | Professional | None | $954.99 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,778.28 Typical High $2,511.89 | Professional | 50 · Both sides | $1,412.54 | $1,778.28 | $2,511.89 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,344.23 | Facility | None | $1,023.29 | $1,445.44 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,737.80 | Facility | None | $34.67 | $512.86 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $6,918.31 | Professional | None | $1,071.52 | $1,659.59 | $6,918.31 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,513.56 | $2,041.74 |
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 $549.54 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Where Kentucky 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.