How much rates vary
Facilitymedian $3,981 · 10th to 90th $537 to $14,125Professionalmedian $1,318 · 10th to 90th $1,000 to $2,042
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 $1,513.56 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,513.56 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $6,606.93 Typical High $14,125.38 | Facility | None | $3,311.31 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,412.54 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,309.57 Typical High $17,782.79 | Facility | None | $660.69 | $6,309.57 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,000.00 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $1,230.27 Typical High $1,862.09 | Professional | None | $19.05 | $1,230.27 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $1,584.89 | Professional | None | $16.22 | $16.22 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,265.80 | Facility | None | $1,071.52 | $1,071.52 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $1,071.52 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,288.25 | $1,862.09 |
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 $616.60 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,071.52 |
Where Nevada sits
The same service costs 14.8 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 $28,001MD $1,894
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.