How much rates vary
Facilitymedian $4,365 · 10th to 90th $525 to $17,378Professionalmedian $1,738 · 10th to 90th $1,259 to $2,630
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 $1,737.80 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,737.80 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $3,981.07 | Professional | None | $1,621.81 | $1,737.80 | $3,981.07 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $9,772.37 Typical High $27,542.29 | Facility | None | $4,897.79 | $9,772.37 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,479.11 | $1,819.70 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,348.96 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $25.70 Median $1,659.59 Typical High $2,344.23 | Professional | None | $25.70 | $1,659.59 | $2,344.23 |
Hometown Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $1,995.26 | Professional | None | $21.88 | $21.88 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,265.80 | Facility | None | $1,348.96 | $1,348.96 | $4,265.80 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,737.80 | $2,630.27 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $173.78 | $173.78 |
Where Nevada 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.