How much rates vary
Facilitymedian $6,310 · 10th to 90th $977 to $12,589Professionalmedian $1,862 · 10th to 90th $1,288 to $2,884
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,288.25 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,041.74 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,819.70 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,288.25 | $1,659.59 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,621.81 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,398.83 | Facility | None | $1,148.15 | $2,290.87 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,238.72 | Professional | None | $794.33 | $1,148.15 | $2,238.72 |
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 $1,445.44 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,819.70 | $2,884.03 |
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 $645.65 Median $645.65 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,122.02 |
Where Colorado sits
The same service costs 9.0 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 $17,266MD $1,911
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.