How much rates vary
Facilitymedian $8,511 · 10th to 90th $977 to $15,488Professionalmedian $2,042 · 10th to 90th $1,413 to $3,162
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 $1,412.54 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,412.54 | $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 $1,584.89 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,238.72 | $3,311.31 |
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 $1,479.11 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,995.26 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,412.54 | $1,819.70 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,778.28 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $2,630.27 | Facility | None | $1,230.27 | $2,511.89 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,398.83 | Professional | None | $870.96 | $1,230.27 | $2,398.83 |
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 $1,584.89 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,041.74 | $3,162.28 |
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 $707.95 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,230.27 |
Where Colorado sits
The same service costs 12.0 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 $24,859MD $2,076
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.