How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,000 to $14,791Professionalmedian $1,905 · 10th to 90th $1,445 to $3,020
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 $1,412.54 Median $1,479.11 Typical High $6,025.60 | Professional | None | $1,412.54 | $1,479.11 | $6,025.60 |
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 $1,445.44 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,905.46 | $3,019.95 |
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 $1,621.81 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,621.81 | $1,995.26 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,479.11 | $1,862.09 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,659.59 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $2,511.89 | Facility | None | $1,174.90 | $2,344.23 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,174.90 | Professional | None | $831.76 | $831.76 | $1,174.90 |
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 $1,659.59 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,137.96 | $3,388.44 |
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 $707.95 Median $741.31 Typical High $1,023.29 | Professional | 52 · Reduced service | $707.95 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | 53 · Discontinued | $288.40 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $302.00 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $204.17 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,412.54 |
Where Colorado sits
The same service costs 7.5 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 $16,075MD $2,147
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.