How much rates vary
Facilitymedian $2,951 · 10th to 90th $525 to $10,471Professionalmedian $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 $1,122.02 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,122.02 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $14,454.40 | Facility | None | $2,951.21 | $5,623.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,348.96 | $2,398.83 |
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 $1,096.48 Typical High $1,862.09 | Professional | None | $977.24 | $1,096.48 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $1,202.26 Typical High $1,819.70 | Professional | None | $16.98 | $1,202.26 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $1,584.89 | Professional | None | $14.45 | $14.45 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,047.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,047.13 | $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 $562.34 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $831.76 |
Where Nevada 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.