How much rates vary
Facilitymedian $2,951 · 10th to 90th $363 to $8,913Professionalmedian $1,380 · 10th to 90th $1,072 to $2,138
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 $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,302.69 | Facility | None | $2,951.21 | $5,623.41 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,513.56 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $6,309.57 | Facility | None | $537.03 | $758.58 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,071.52 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $15.85 Median $1,288.25 Typical High $1,949.84 | Professional | None | $15.85 | $1,288.25 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $1,698.24 | Professional | None | $13.49 | $13.49 | $1,698.24 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
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 $263.03 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $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 $912.01 Median $912.01 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,122.02 |
Where Nevada sits
The same service costs 13.1 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 $24,687MD $1,882
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.