How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $7,586Professionalmedian $1,820 · 10th to 90th $1,122 to $2,399
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 $2,884.03 Typical High $10,715.19 | Facility | None | $1,905.46 | $2,884.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,862.09 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,511.38 | Facility | None | $2,754.23 | $4,570.88 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,737.80 | $1,995.26 | $3,235.94 |
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 $977.24 Median $1,479.11 Typical High $2,344.23 | Professional | None | $977.24 | $1,479.11 | $2,344.23 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $1,584.89 Typical High $2,290.87 | Professional | None | $15.14 | $1,584.89 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $2,398.83 | Professional | None | $11.22 | $11.22 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $4,265.80 | Facility | None | $1,584.89 | $1,584.89 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,445.44 | $3,090.30 |
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 $1,122.02 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,698.24 | $2,137.96 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,318.26 |
Where Nevada sits
The same service costs 7.6 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 $18,140MD $2,382
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.