How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,089 to $15,488Professionalmedian $1,698 · 10th to 90th $1,122 to $2,570
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 $3,235.94 Typical High $8,912.51 | Facility | None | $2,570.40 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,122.02 | $2,187.76 |
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 $1,348.96 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,905.46 | $2,818.38 |
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 $1,202.26 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,659.59 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Facility | None | $1,071.52 | $1,479.11 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,445.44 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,023.29 | $2,041.74 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,995.26 | Professional | None | $707.95 | $1,023.29 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,698.24 | $2,691.53 |
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 $524.81 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $891.25 |
Where Colorado sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.