How much rates vary
Facilitymedian $2,188 · 10th to 90th $468 to $21,380Professionalmedian $2,042 · 10th to 90th $1,259 to $3,020
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 $2,041.74 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,659.59 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,230.27 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,230.27 | $2,041.74 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $323.59 Typical High $380.19 | Professional | 80 · Assistant surgeon | $199.53 | $323.59 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $281.84 Typical High $338.84 | Professional | AS · PA/NP assist | $173.78 | $281.84 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,238.72 | Facility | None | $1,174.90 | $1,412.54 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,949.84 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,454.71 | Facility | None | $34.67 | $512.86 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $6,606.93 | Professional | None | $1,445.44 | $2,754.23 | $6,606.93 |
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 $1,819.70 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,819.70 | $2,398.83 | $3,090.30 |
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 $758.58 Median $831.76 Typical High $1,096.48 | Professional | 52 · Reduced service | $758.58 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $436.52 | Professional | 53 · Discontinued | $309.03 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $218.78 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $218.78 |
Where Kentucky 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.