How much rates vary
Facilitymedian $2,884 · 10th to 90th $525 to $6,918Professionalmedian $955 · 10th to 90th $776 to $1,549
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 $912.01 Median $3,981.07 Typical High $10,715.19 | Facility | None | $912.01 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | None | $912.01 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $7,943.28 | Facility | None | $2,754.23 | $4,570.88 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,949.84 | Professional | None | $891.25 | $1,096.48 | $1,949.84 |
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 $776.25 Median $776.25 Typical High $1,479.11 | Professional | None | $776.25 | $776.25 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $18.20 Median $977.24 Typical High $1,548.82 | Professional | None | $18.20 | $977.24 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $1,348.96 | Professional | None | $15.49 | $15.49 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Facility | None | $912.01 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $831.76 Median $977.24 Typical High $1,548.82 | Professional | None | $831.76 | $977.24 | $1,548.82 |
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 $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $691.83 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $660.69 |
Where Nevada sits
The same service costs 10.1 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 $16,050AR $1,584
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.