How much rates vary
Facilitymedian $2,951 · 10th to 90th $525 to $7,413Professionalmedian $1,514 · 10th to 90th $1,230 to $2,630
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 $1,513.56 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,513.56 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $7,943.28 | Facility | None | $2,951.21 | $5,623.41 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,584.89 | $2,951.21 |
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 $1,096.48 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,230.27 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $1,513.56 Typical High $2,041.74 | Professional | None | $16.98 | $1,513.56 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $1,778.28 | Professional | None | $14.45 | $14.45 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,265.80 | Facility | None | $1,174.90 | $1,174.90 | $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 $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,737.80 | $2,818.38 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Nevada 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.