How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,905 · 10th to 90th $1,318 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 $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 $1,318.26 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,318.26 | $2,570.40 |
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 $1,479.11 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,089.30 | $3,090.30 |
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 $1,380.38 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,862.09 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,884.03 | Facility | None | $1,318.26 | $1,698.24 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,659.59 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,454.71 | Facility | None | $1,148.15 | $2,290.87 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $2,238.72 | Professional | None | $812.83 | $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 $1,513.56 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,905.46 | $3,019.95 |
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 $660.69 Median $660.69 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,174.90 |
Where Colorado sits
The same service costs 8.9 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 $17,308MD $1,943
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.