How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $7,586Professionalmedian $1,622 · 10th to 90th $1,202 to $2,138
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 $1,698.24 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,548.82 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,778.28 | $2,884.03 |
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 $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
Hometown Health Setting Professional Modifier None Typical Low $21.88 Median $1,412.54 Typical High $2,041.74 | Professional | None | $21.88 | $1,412.54 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $2,137.96 | Professional | None | $16.60 | $16.60 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,265.80 | Facility | None | $1,412.54 | $1,412.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,691.53 | Professional | None | $954.99 | $1,258.93 | $2,691.53 |
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 $1,202.26 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,513.56 | $2,041.74 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Where Nevada sits
The same service costs 8.2 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 $17,891MD $2,184
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.