How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,089 to $15,488Professionalmedian $1,175 · 10th to 90th $794 to $1,862
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 $2,187.76 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,187.76 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $2,630.27 | Professional | None | $741.31 | $794.33 | $2,630.27 |
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 $933.25 Median $1,318.26 Typical High $1,949.84 | Professional | None | $933.25 | $1,318.26 | $1,949.84 |
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 $831.76 Median $1,122.02 Typical High $1,548.82 | Professional | None | $831.76 | $1,122.02 | $1,548.82 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Facility | None | $741.31 | $977.24 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,548.82 | Professional | None | $724.44 | $1,023.29 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,479.11 Typical High $1,548.82 | Facility | None | $724.44 | $1,479.11 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,412.54 | Professional | None | $512.86 | $724.44 | $1,412.54 |
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 $870.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $870.96 | $1,148.15 | $1,819.70 |
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 $371.54 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Where Colorado sits
The same service costs 11.6 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 $23,484TX $2,029
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.