How much rates vary
Facilitymedian $2,951 · 10th to 90th $525 to $8,913Professionalmedian $1,148 · 10th to 90th $851 to $1,738
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 $1,047.13 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,047.13 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,302.69 | Facility | None | $2,951.21 | $5,623.41 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,202.26 | $2,187.76 |
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 $851.14 Median $870.96 Typical High $1,659.59 | Professional | None | $851.14 | $870.96 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $14.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $14.13 | $1,047.13 | $1,584.89 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $1,380.38 | Professional | None | $12.02 | $12.02 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $912.01 Median $1,122.02 Typical High $1,698.24 | Professional | None | $912.01 | $1,122.02 | $1,698.24 |
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 $524.81 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $912.01 |
Where Nevada sits
The same service costs 14.5 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 $24,354MD $1,684
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.