How much rates vary
Facilitymedian $4,266 · 10th to 90th $525 to $14,125Professionalmedian $1,995 · 10th to 90th $1,585 to $3,162
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 $1,905.46 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,905.46 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,949.84 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $9,120.11 Typical High $17,378.01 | Facility | None | $4,570.88 | $9,120.11 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,238.72 | $4,073.80 |
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 $1,584.89 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,584.89 | $3,090.30 |
Hometown Health Setting Professional Modifier None Typical Low $25.70 Median $1,995.26 Typical High $3,019.95 | Professional | None | $25.70 | $1,995.26 | $3,019.95 |
Hometown Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $2,630.27 | Professional | None | $22.39 | $22.39 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,265.80 | Facility | None | $1,778.28 | $1,778.28 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $1,737.80 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,041.74 | $3,090.30 |
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 $954.99 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $954.99 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,348.96 |
Where Nevada 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.