How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,023 to $15,488Professionalmedian $1,585 · 10th to 90th $1,072 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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $5,495.41 | Professional | None | $1,047.13 | $1,047.13 | $5,495.41 |
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 $1,230.27 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,737.80 | $2,570.40 |
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 $1,122.02 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,548.82 | $2,089.30 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,380.38 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,412.54 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $2,137.96 | Facility | None | $1,000.00 | $1,995.26 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,949.84 | Professional | None | $707.95 | $1,000.00 | $1,949.84 |
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 $1,174.90 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,548.82 | $2,454.71 |
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 $524.81 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $891.25 |
Where Colorado sits
The same service costs 16.4 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 $28,429MD $1,737
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.