How much rates vary
Facilitymedian $1,585 · 10th to 90th $457 to $9,120Professionalmedian $1,230 · 10th to 90th $871 to $1,995
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 $794.33 Median $1,318.26 Typical High $2,630.27 | Facility | None | $794.33 | $1,318.26 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,819.70 | Professional | None | $977.24 | $1,202.26 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $10,715.19 | Facility | None | $3,235.94 | $5,495.41 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,513.56 | Professional | None | $831.76 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,778.28 Typical High $2,290.87 | Professional | 50 · Both sides | $1,258.93 | $1,778.28 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $1,445.44 | Facility | None | $758.58 | $912.01 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,479.11 | Professional | None | $891.25 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,584.89 | Facility | None | $34.67 | $512.86 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,949.84 Typical High $6,456.54 | Professional | None | $933.25 | $1,949.84 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $28,183.83 | Facility | None | $354.81 | $912.01 | $28,183.83 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,584.89 | $2,089.30 |
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 $1,071.52 | Professional | 54 · Surgery only | $741.31 | $812.83 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $1,000.00 |
Where Kentucky 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.