How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,000 to $21,380Professionalmedian $2,754 · 10th to 90th $1,862 to $4,169
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,819.70 | $1,819.70 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $15,135.61 Typical High $25,703.96 | Facility | None | $9,772.37 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,466.84 | Professional | None | $2,137.96 | $3,019.95 | $4,466.84 |
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 $1,905.46 Median $2,691.53 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,691.53 | $3,630.78 |
Denver HMP Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $4,466.84 | Facility | None | $1,819.70 | $2,344.23 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,511.89 | $3,801.89 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $3,801.89 | Facility | None | $1,778.28 | $3,548.13 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,778.28 | $3,467.37 |
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 $2,089.30 Median $2,691.53 Typical High $4,265.80 | Professional | None | $2,089.30 | $2,691.53 | $4,265.80 |
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 $912.01 Median $912.01 Typical High $1,096.48 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $436.52 | Professional | 53 · Discontinued | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,513.56 |
Where Colorado sits
The same service costs 13.4 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 $34,930MD $2,604
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.