How much rates vary
Facilitymedian $5,754 · 10th to 90th $759 to $12,303Professionalmedian $1,660 · 10th to 90th $977 to $2,512
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,659.59 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $11,481.54 Typical High $13,803.84 | Facility | None | $3,715.35 | $11,481.54 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,398.83 | Professional | None | $954.99 | $1,621.81 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,398.83 Typical High $3,630.78 | Professional | 50 · Both sides | $1,380.38 | $2,398.83 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,621.81 | $2,511.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,778.28 | $1,819.70 |
Health New England Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,047.13 | $1,778.28 | $3,467.37 |
4 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 54 · Surgery only Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $169.82 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $112.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $1,148.15 | $1,148.15 |
Where Connecticut sits
The same service costs 9.4 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 $15,900MD $1,684
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.