How much rates vary
Facilitymedian $11,482 · 10th to 90th $933 to $20,417Professionalmedian $1,122 · 10th to 90th $832 to $1,862
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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $6,456.54 | Professional | None | $794.33 | $891.25 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $13,182.57 Typical High $20,892.96 | Facility | None | $9,549.93 | $13,182.57 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,778.28 | Professional | None | $851.14 | $1,122.02 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $4,786.30 | Facility | None | $645.65 | $2,137.96 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,584.89 | Professional | None | $912.01 | $1,148.15 | $1,584.89 |
Denver HMP Setting Facility Modifier None Typical Low $891.25 Median $954.99 Typical High $1,778.28 | Facility | None | $891.25 | $954.99 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,584.89 | Professional | None | $676.08 | $1,000.00 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $1,479.11 | Facility | None | $707.95 | $1,412.54 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $707.95 | Professional | None | $501.19 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,318.26 | $1,995.26 |
6 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 $426.58 Median $436.52 Typical High $602.56 | Professional | 52 · Reduced service | $426.58 | $436.52 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $239.88 | Professional | 53 · Discontinued | $169.82 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $891.25 | Professional | 54 · Surgery only | $645.65 | $660.69 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $181.97 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $120.23 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $831.76 |
Where Colorado sits
The same service costs 18.7 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 $26,826MD $1,433
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.