How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $9,333Professionalmedian $1,202 · 10th to 90th $977 to $1,995
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 $1,096.48 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,096.48 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $12,022.64 | Facility | None | $2,951.21 | $5,623.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,380.38 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,905.46 | Professional | None | $977.24 | $977.24 | $1,905.46 |
Hometown Health Setting Professional Modifier None Typical Low $12.30 Median $1,174.90 Typical High $1,698.24 | Professional | None | $12.30 | $1,174.90 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $1,479.11 | Professional | None | $10.47 | $10.47 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,230.27 | $2,041.74 |
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 $549.54 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $851.14 |
Where Nevada 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.