How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $42,658Professionalmedian $1,445 · 10th to 90th $1,023 to $7,943
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 $3,548.13 Median $10,000.00 Typical High $21,379.62 | Facility | None | $3,548.13 | $10,000.00 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $6,606.93 | Professional | None | $1,023.29 | $1,071.52 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $11,748.98 Typical High $24,547.09 | Facility | None | $6,918.31 | $11,748.98 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $4,365.16 | Professional | None | $1,380.38 | $1,548.82 | $4,365.16 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,344.23 | Professional | None | $851.14 | $1,230.27 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,621.81 | Professional | None | $954.99 | $1,202.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,318.26 | $3,311.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,412.54 | Professional | None | $954.99 | $1,174.90 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,884.03 | Professional | None | $977.24 | $1,230.27 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,120.11 Typical High $9,120.11 | Professional | None | $7,943.28 | $9,120.11 | $9,120.11 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,047.13 | $1,318.26 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,467.37 | Professional | None | $954.99 | $1,318.26 | $3,467.37 |
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 $512.86 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $128.82 |
Where California sits
The same service costs 15.0 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 $27,402MD $1,821
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.