How much rates vary
Facilitymedian $1,995 · 10th to 90th $468 to $21,380Professionalmedian $1,950 · 10th to 90th $1,148 to $2,754
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 $1,000.00 Median $1,862.09 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,862.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $16,982.44 Typical High $30,902.95 | Facility | None | $5,888.44 | $16,982.44 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,949.84 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $309.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $177.83 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $269.15 Typical High $323.59 | Professional | AS · PA/NP assist | $154.88 | $269.15 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,288.25 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,737.80 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,187.76 | Facility | None | $34.67 | $691.83 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $6,025.60 | Professional | None | $1,288.25 | $2,454.71 | $6,025.60 |
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 $1,621.81 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,621.81 | $2,187.76 | $2,754.23 |
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 $691.83 Median $758.58 Typical High $1,000.00 | Professional | 52 · Reduced service | $691.83 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $275.42 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $302.00 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $199.53 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $199.53 |
Where Kentucky 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.