How much rates vary
Facilitymedian $8,511 · 10th to 90th $977 to $15,488Professionalmedian $1,660 · 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 $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,096.48 | $1,698.24 |
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 $1,288.25 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,778.28 | $2,630.27 |
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 $1,621.81 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,621.81 | $2,187.76 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,548.82 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,238.72 | Facility | None | $1,071.52 | $2,137.96 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,089.30 | Professional | None | $758.58 | $1,071.52 | $2,089.30 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,621.81 | $2,570.40 |
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 $537.03 Median $537.03 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $912.01 |
Where Colorado sits
The same service costs 15.4 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 $28,500MD $1,851
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.