How much rates vary
Facilitymedian $4,074 · 10th to 90th $794 to $11,482Professionalmedian $1,047 · 10th to 90th $851 to $1,514
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 $1,000.00 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $933.25 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $12,882.50 | Facility | None | $2,884.03 | $7,079.46 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | None | $870.96 | $1,047.13 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,348.96 | Professional | None | $912.01 | $1,023.29 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,548.82 | Professional | None | $851.14 | $1,000.00 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,659.59 | Facility | None | $1,000.00 | $1,122.02 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Sentara Setting Facility Modifier None Typical Low $776.25 Median $1,737.80 Typical High $5,623.41 | Facility | None | $776.25 | $1,737.80 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,290.87 | Professional | None | $794.33 | $1,174.90 | $2,290.87 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,737.80 | Professional | None | $724.44 | $1,096.48 | $1,737.80 |
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 $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $691.83 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $707.95 |
Where Virginia 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.