How much rates vary
Facilitymedian $3,311 · 10th to 90th $468 to $10,965Professionalmedian $282 · 10th to 90th $224 to $479
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 $245.47 Median $3,981.07 Typical High $10,715.19 | Facility | None | $245.47 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | None | $245.47 | $245.47 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $6,606.93 Typical High $14,125.38 | Facility | None | $3,311.31 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $575.44 | Professional | None | $263.03 | $316.23 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $436.52 | Professional | None | $223.87 | $229.09 | $436.52 |
Hometown Health Setting Professional Modifier None Typical Low $4.68 Median $269.15 Typical High $407.38 | Professional | None | $4.68 | $269.15 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $346.74 | Professional | None | $3.98 | $3.98 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $4,265.80 | Facility | None | $234.42 | $234.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $234.42 Median $281.84 Typical High $489.78 | Professional | None | $234.42 | $281.84 | $489.78 |
5 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 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 52 · Reduced service | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $25.12 |
Where Nevada sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.