How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,710Professionalmedian $933 · 10th to 90th $741 to $2,042
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 $933.25 Median $4,897.79 Typical High $7,762.47 | Facility | None | $933.25 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $933.25 | Professional | None | $630.96 | $758.58 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,348.96 | Professional | None | $741.31 | $870.96 | $1,348.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,202.26 | Professional | None | $758.58 | $851.14 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,659.59 | Professional | None | $776.25 | $851.14 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $8,709.64 | Facility | None | $54.95 | $1,230.27 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $5,370.32 | Professional | None | $891.25 | $1,698.24 | $5,370.32 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,041.74 | Professional | None | $812.83 | $1,122.02 | $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 $316.23 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $549.54 |
Where Missouri sits
The same service costs 11.3 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 $15,814MD $1,394
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.