How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,023 to $25,704Professionalmedian $2,138 · 10th to 90th $1,585 to $3,388
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 $1,479.11 Median $1,698.24 Typical High $5,495.41 | Professional | None | $1,479.11 | $1,698.24 | $5,495.41 |
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 $1,621.81 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,137.96 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,187.76 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,698.24 | $1,819.70 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,905.46 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $2,818.38 | Facility | None | $1,348.96 | $2,691.53 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,348.96 | Professional | None | $933.25 | $933.25 | $1,348.96 |
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 $1,905.46 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,511.89 | $3,801.89 |
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 $812.83 Median $831.76 Typical High $1,148.15 | Professional | 52 · Reduced service | $812.83 | $831.76 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $457.09 | Professional | 53 · Discontinued | $323.59 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $346.74 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $229.09 |
Where Colorado sits
The same service costs 24.1 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 $53,525MD $2,222
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.