How much rates vary
Facilitymedian $3,802 · 10th to 90th $525 to $10,715Professionalmedian $1,318 · 10th to 90th $955 to $1,995
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 $1,318.26 Median $4,786.30 Typical High $7,244.36 | Facility | None | $1,318.26 | $4,786.30 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $4,265.80 | Professional | None | $1,288.25 | $1,318.26 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,585.78 Typical High $13,803.84 | Facility | None | $3,801.89 | $7,585.78 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,380.38 | $2,454.71 |
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 $954.99 Median $1,023.29 Typical High $1,862.09 | Professional | None | $954.99 | $1,023.29 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $1,258.93 Typical High $1,778.28 | Professional | None | $19.05 | $1,258.93 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $1,513.56 | Professional | None | $16.60 | $16.60 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $4,265.80 | Facility | None | $1,023.29 | $1,023.29 | $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 $954.99 Median $1,318.26 Typical High $1,995.26 | Professional | None | $954.99 | $1,318.26 | $1,995.26 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Where Nevada 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.