How much rates vary
Facilitymedian $5,248 · 10th to 90th $631 to $50,119Professionalmedian $1,318 · 10th to 90th $871 to $4,169
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 $977.24 Median $8,128.31 Typical High $19,054.61 | Facility | None | $977.24 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,949.84 | Professional | None | $891.25 | $954.99 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,511.38 Typical High $17,782.79 | Facility | None | $4,897.79 | $8,511.38 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,548.82 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $2,398.83 | Professional | None | $870.96 | $1,258.93 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,949.84 | Professional | None | $831.76 | $1,023.29 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,630.27 | Professional | None | $933.25 | $1,096.48 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,288.25 | Professional | None | $870.96 | $1,023.29 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,344.23 | Professional | None | $794.33 | $1,023.29 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,630.27 | Professional | None | $891.25 | $1,096.48 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,818.38 | Professional | None | $794.33 | $1,096.48 | $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 $446.68 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $758.58 |
Where California sits
The same service costs 9.6 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 $15,506MD $1,609
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.