How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,122 to $9,333Professionalmedian $1,122 · 10th to 90th $891 to $1,778
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 $1,023.29 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,023.29 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
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 $1,071.52 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,288.25 | $2,187.76 |
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 $891.25 Median $891.25 Typical High $1,737.80 | Professional | None | $891.25 | $891.25 | $1,737.80 |
Hometown Health Setting Professional Modifier None Typical Low $17.78 Median $1,071.52 Typical High $1,621.81 | Professional | None | $17.78 | $1,071.52 | $1,621.81 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $1,380.38 | Professional | None | $15.14 | $15.14 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Facility | None | $933.25 | $933.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $933.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $933.25 | $1,148.15 | $1,737.80 |
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 $512.86 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $776.25 |
Where Nevada sits
The same service costs 9.8 times more in Maine than in Arkansas. 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 $23,866AR $2,433
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.