How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,514 to $14,125Professionalmedian $1,445 · 10th to 90th $1,096 to $1,950
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 $1,513.56 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,513.56 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
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 $1,380.38 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,548.82 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,309.57 Typical High $17,782.79 | Facility | None | $660.69 | $6,309.57 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,148.15 | $1,905.46 |
Hometown Health Setting Professional Modifier None Typical Low $18.20 Median $1,258.93 Typical High $1,819.70 | Professional | None | $18.20 | $1,258.93 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $1,905.46 | Professional | None | $13.80 | $13.80 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,265.80 | Facility | None | $1,258.93 | $1,258.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,454.71 | Professional | None | $851.14 | $1,122.02 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,380.38 | $1,905.46 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Nevada sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.