How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $7,413Professionalmedian $1,380 · 10th to 90th $1,047 to $2,188
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 $1,288.25 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,288.25 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $8,317.64 | Facility | None | $2,754.23 | $4,570.88 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,479.11 | $2,691.53 |
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 $1,047.13 Median $1,047.13 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,047.13 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $20.42 Median $1,258.93 Typical High $1,949.84 | Professional | None | $20.42 | $1,258.93 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $1,659.59 | Professional | None | $17.38 | $17.38 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,265.80 | Facility | None | $1,122.02 | $1,122.02 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $1,122.02 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,348.96 | $2,238.72 |
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 $316.23 | Professional | 53 · Discontinued | $257.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,096.48 |
Where Nevada 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.