How much rates vary
Facilitymedian $1,698 · 10th to 90th $513 to $12,589Professionalmedian $2,291 · 10th to 90th $1,479 to $3,890
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 $1,698.24 Median $6,760.83 Typical High $10,964.78 | Facility | None | $1,698.24 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,778.28 | $4,466.84 |
Ambetter Setting Professional Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,691.53 | $3,311.31 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,388.44 Typical High $23,988.33 | Facility | None | $1,122.02 | $3,388.44 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,344.23 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $426.58 Typical High $588.84 | Professional | 80 · Assistant surgeon | $257.04 | $426.58 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $316.23 Typical High $512.86 | Professional | AS · PA/NP assist | $223.87 | $316.23 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,778.28 | $2,884.03 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $8,128.31 | Professional | None | $1,584.89 | $1,819.70 | $8,128.31 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,630.27 | $2,884.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,621.81 | $2,570.40 | $5,128.61 |
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 $831.76 Median $851.14 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $190.55 |
Where Georgia 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.