How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,023 to $17,783Professionalmedian $1,950 · 10th to 90th $1,349 to $2,951
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 $1,348.96 Median $3,235.94 Typical High $8,912.51 | Facility | None | $1,348.96 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,380.38 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,413.10 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,137.96 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna 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 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Facility | None | $1,348.96 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,698.24 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $2,511.89 | Facility | None | $1,202.26 | $2,398.83 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,344.23 | Professional | None | $831.76 | $1,202.26 | $2,344.23 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,995.26 | $3,090.30 |
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 $676.08 Median $676.08 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,202.26 |
Where Colorado sits
The same service costs 14.0 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 $28,122MD $2,008
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.