How much rates vary
Facilitymedian $3,311 · 10th to 90th $525 to $10,965Professionalmedian $912 · 10th to 90th $708 to $1,479
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 $870.96 Median $3,981.07 Typical High $10,715.19 | Facility | None | $870.96 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | None | $870.96 | $870.96 | $912.01 |
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 $851.14 Median $1,023.29 Typical High $1,819.70 | Professional | None | $851.14 | $1,023.29 | $1,819.70 |
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 $707.95 Median $724.44 Typical High $1,380.38 | Professional | None | $707.95 | $724.44 | $1,380.38 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $891.25 Typical High $1,348.96 | Professional | None | $13.18 | $891.25 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $1,174.90 | Professional | None | $11.22 | $11.22 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,265.80 | Facility | None | $794.33 | $794.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $794.33 Median $912.01 Typical High $1,445.44 | Professional | None | $794.33 | $912.01 | $1,445.44 |
6 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 $436.52 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $645.65 |
Where Nevada sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.