How much rates vary
Facilitymedian $2,884 · 10th to 90th $537 to $13,804Professionalmedian $1,380 · 10th to 90th $1,023 to $3,981
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 $1,698.24 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,698.24 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,174.90 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,981.07 Typical High $13,489.63 | Facility | None | $1,412.54 | $3,981.07 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $3,019.95 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $3,019.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,318.26 | Professional | None | $912.01 | $977.24 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $28,183.83 | Facility | None | $501.19 | $851.14 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,818.38 | Professional | None | $933.25 | $1,288.25 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $11,748.98 | Facility | None | $54.95 | $1,230.27 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,691.53 Typical High $7,943.28 | Professional | None | $1,412.54 | $2,691.53 | $7,943.28 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $15,848.93 | Facility | None | $467.74 | $2,344.23 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,737.80 | $2,951.21 |
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 $776.25 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $776.25 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $891.25 |
Where Missouri 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.