How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,000 to $13,804Professionalmedian $1,778 · 10th to 90th $1,349 to $2,818
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $5,754.40 | Professional | None | $1,348.96 | $1,412.54 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $9,332.54 Typical High $16,218.10 | Facility | None | $5,888.44 | $9,332.54 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,778.28 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,905.46 | $2,511.89 |
Denver HMP Setting Facility Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,818.38 | Facility | None | $1,412.54 | $1,778.28 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,584.89 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,238.72 Typical High $2,398.83 | Facility | None | $1,122.02 | $2,238.72 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,122.02 | Professional | None | $794.33 | $794.33 | $1,122.02 |
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 $1,548.82 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,548.82 | $2,041.74 | $3,162.28 |
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 $676.08 Median $707.95 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $707.95 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $281.84 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,318.26 |
Where Colorado sits
The same service costs 8.1 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 $15,945MD $1,975
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.