How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,000 to $15,488Professionalmedian $2,138 · 10th to 90th $1,479 to $3,388
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 $1,479.11 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,479.11 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,344.23 | $3,467.37 |
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 $1,548.82 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,137.96 | $2,818.38 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,235.94 | Facility | None | $1,479.11 | $1,949.84 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,862.09 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $2,754.23 | Facility | None | $1,318.26 | $2,630.27 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,570.40 | Professional | None | $912.01 | $1,318.26 | $2,570.40 |
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 $1,698.24 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,187.76 | $3,388.44 |
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 $741.31 Median $741.31 Typical High $954.99 | Professional | 52 · Reduced service | $741.31 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 53 · Discontinued | $295.12 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,318.26 |
Where Colorado sits
The same service costs 11.6 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 $24,998MD $2,147
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.