How much rates vary
Facilitymedian $4,677 · 10th to 90th $575 to $23,442Professionalmedian $91 · 10th to 90th $71 to $162
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 $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $3,715.35 | Professional | None | $79.43 | $79.43 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $141.25 | Professional | None | $70.79 | $87.10 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $190.55 | Professional | None | $87.10 | $114.82 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $190.55 | Professional | None | $87.10 | $114.82 | $190.55 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $120.23 | Professional | None | $60.26 | $83.18 | $120.23 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | None | $83.18 | $83.18 | $125.89 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $213.80 | Professional | None | $85.11 | $117.49 | $213.80 |
5 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 $39.81 Median $39.81 Typical High $181.97 | Professional | 52 · Reduced service | $39.81 | $39.81 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $72.44 | Professional | 53 · Discontinued | $15.85 | $15.85 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $269.15 | Professional | 54 · Surgery only | $58.88 | $58.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $54.95 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $36.31 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $36.31 |
Where Ohio sits
The same service costs 121.8 times more in Maine than in Montana. 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 $33,236MT $273
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.