How much rates vary
Facilitymedian $2,951 · 10th to 90th $537 to $23,988Professionalmedian $1,122 · 10th to 90th $891 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 $1,122.02 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,122.02 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $2,818.38 | Professional | None | $1,096.48 | $1,122.02 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $18,620.87 Typical High $25,118.86 | Facility | None | $6,025.60 | $18,620.87 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,137.96 | Professional | None | $977.24 | $1,174.90 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $21,877.62 | Facility | None | $562.34 | $912.01 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,737.80 | Professional | None | $870.96 | $954.99 | $1,737.80 |
Hometown Health Setting Professional Modifier None Typical Low $16.22 Median $1,148.15 Typical High $1,513.56 | Professional | None | $16.22 | $1,148.15 | $1,513.56 |
Hometown Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $1,288.25 | Professional | None | $13.80 | $13.80 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $4,265.80 | Facility | None | $870.96 | $870.96 | $4,265.80 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $870.96 | $1,122.02 | $1,737.80 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Nevada 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.