How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $7,586Professionalmedian $933 · 10th to 90th $562 to $1,202
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 $954.99 Median $3,981.07 Typical High $10,715.19 | Facility | None | $954.99 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $870.96 Median $1,000.00 Typical High $1,621.81 | Professional | None | $870.96 | $1,000.00 | $1,621.81 |
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 $562.34 Median $741.31 Typical High $1,174.90 | Professional | None | $562.34 | $741.31 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $831.76 Typical High $1,174.90 | Professional | None | $13.18 | $831.76 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $1,230.27 | Professional | None | $10.00 | $10.00 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,265.80 | Facility | None | $831.76 | $831.76 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,584.89 | Professional | None | $549.54 | $741.31 | $1,584.89 |
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 $562.34 Median $870.96 Typical High $1,096.48 | Professional | None | $562.34 | $870.96 | $1,096.48 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Nevada sits
The same service costs 11.4 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 $16,997MD $1,496
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.