How much rates vary
Facilitymedian $6,607 · 10th to 90th $631 to $63,096Professionalmedian $1,660 · 10th to 90th $1,230 to $9,333
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 $2,818.38 Median $9,120.11 Typical High $19,498.45 | Facility | None | $2,818.38 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,288.25 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $17,378.01 Typical High $37,153.52 | Facility | None | $7,079.46 | $17,378.01 | $37,153.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,659.59 | $1,862.09 | $5,128.61 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,479.11 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,412.54 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,964.78 | Facility | None | $660.69 | $1,348.96 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,584.89 | $3,981.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,380.38 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,445.44 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $10,964.78 Typical High $10,964.78 | Professional | None | $9,332.54 | $10,964.78 | $10,964.78 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,584.89 | $3,981.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,584.89 | $4,073.80 |
5 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 $616.60 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $151.36 |
Where California sits
The same service costs 25.6 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 $53,236MD $2,076
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.