How much rates vary
Facilitymedian $3,162 · 10th to 90th $537 to $10,000Professionalmedian $891 · 10th to 90th $661 to $1,380
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 $891.25 Median $3,162.28 Typical High $7,244.36 | Facility | None | $891.25 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $4,168.69 | Professional | None | $891.25 | $891.25 | $4,168.69 |
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 $776.25 Median $933.25 Typical High $1,737.80 | Professional | None | $776.25 | $933.25 | $1,737.80 |
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 $660.69 Median $707.95 Typical High $1,288.25 | Professional | None | $660.69 | $707.95 | $1,288.25 |
Hometown Health Setting Professional Modifier None Typical Low $12.88 Median $870.96 Typical High $1,230.27 | Professional | None | $12.88 | $870.96 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $1,047.13 | Professional | None | $11.22 | $11.22 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $4,265.80 | Facility | None | $707.95 | $707.95 | $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 $660.69 Median $912.01 Typical High $1,380.38 | Professional | None | $660.69 | $912.01 | $1,380.38 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Where Nevada 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.