How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,023 to $25,704Professionalmedian $1,950 · 10th to 90th $1,445 to $3,162
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 $2,570.40 Median $5,495.41 Typical High $12,589.25 | Facility | None | $2,570.40 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $6,456.54 | Professional | None | $1,380.38 | $1,513.56 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,949.84 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $10,964.78 | Facility | None | $645.65 | $2,454.71 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,513.56 | $1,659.59 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,698.24 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $2,570.40 | Facility | None | $1,202.26 | $2,398.83 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,238.72 | $3,467.37 |
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 $724.44 Median $758.58 Typical High $1,023.29 | Professional | 52 · Reduced service | $724.44 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $407.38 | Professional | 53 · Discontinued | $295.12 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $309.03 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $204.17 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $204.17 |
Where Colorado 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.