How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $7,586Professionalmedian $2,089 · 10th to 90th $1,413 to $2,692
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 $2,187.76 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,187.76 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,995.26 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,238.72 | $3,715.35 |
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 $1,258.93 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,659.59 | $2,691.53 |
Hometown Health Setting Professional Modifier None Typical Low $30.90 Median $1,819.70 Typical High $2,570.40 | Professional | None | $30.90 | $1,819.70 | $2,570.40 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $2,691.53 | Professional | None | $22.91 | $22.91 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,265.80 | Facility | None | $1,819.70 | $1,819.70 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,621.81 | $3,467.37 |
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 $1,412.54 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,949.84 | $2,570.40 |
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,513.56 |
Where Nevada sits
The same service costs 6.9 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 $18,419MD $2,652
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.