How much rates vary
Facilitymedian $1,072 · 10th to 90th $501 to $8,128Professionalmedian $1,479 · 10th to 90th $977 to $2,570
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 $1,122.02 Median $5,370.32 Typical High $10,000.00 | Facility | None | $1,122.02 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,174.90 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,737.80 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $12,589.25 | Facility | None | $588.84 | $1,819.70 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,344.23 | Professional | None | $954.99 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $1,737.80 | $2,570.40 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,691.53 | Facility | None | $457.09 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,698.24 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,174.90 | $1,659.59 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,047.13 | $1,737.80 | $3,311.31 |
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 $812.83 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $912.01 |
Where Georgia 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.