How much rates vary
Facilitymedian $3,548 · 10th to 90th $513 to $11,482Professionalmedian $1,047 · 10th to 90th $676 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 $1,905.46 Median $4,265.80 Typical High $12,022.64 | Facility | None | $1,905.46 | $4,265.80 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $7,943.28 | Professional | None | $1,096.48 | $1,737.80 | $7,943.28 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $6,456.54 Typical High $12,589.25 | Facility | None | $954.99 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $891.25 | $1,071.52 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,570.40 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,187.76 | Professional | None | $954.99 | $1,230.27 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,454.71 | Professional | None | $954.99 | $1,230.27 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $912.01 Typical High $1,202.26 | Professional | None | $70.79 | $912.01 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,187.76 | Professional | None | $912.01 | $1,071.52 | $2,187.76 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $5,248.07 | Facility | None | $371.54 | $977.24 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,412.54 | $2,884.03 |
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 $812.83 Typical High $2,137.96 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $426.58 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $288.40 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,995.26 |
Where Ohio 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.