How much rates vary
Facilitymedian $7,079 · 10th to 90th $794 to $14,454Professionalmedian $1,349 · 10th to 90th $871 to $1,820
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 $1,096.48 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,096.48 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,096.48 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $9,332.54 Typical High $16,982.44 | Facility | None | $1,949.84 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,819.70 | Professional | None | $794.33 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $2,041.74 Typical High $2,754.23 | Professional | 50 · Both sides | $1,202.26 | $2,041.74 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,187.76 | Professional | None | $977.24 | $1,380.38 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,819.70 | Professional | None | $933.25 | $1,202.26 | $1,819.70 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,995.26 | Professional | None | $977.24 | $1,380.38 | $1,995.26 |
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 $741.31 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $851.14 |
Where Indiana 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.