How much rates vary
Facilitymedian $7,244 · 10th to 90th $631 to $61,660Professionalmedian $3,236 · 10th to 90th $2,138 to $17,783
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 $2,511.89 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,511.89 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,290.87 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $13,803.84 Typical High $28,840.32 | Facility | None | $7,943.28 | $13,803.84 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $9,549.93 | Professional | None | $2,754.23 | $3,388.44 | $9,549.93 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $5,888.44 Typical High $12,302.69 | Facility | None | $67.61 | $5,888.44 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $6,309.57 | Professional | None | $1,819.70 | $2,570.40 | $6,309.57 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,691.53 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $6,606.93 | Professional | None | $2,344.23 | $2,630.27 | $6,606.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,513.56 | $2,570.40 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $6,760.83 | Professional | None | $2,238.72 | $2,818.38 | $6,760.83 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $19,054.61 | Professional | None | $17,782.79 | $17,782.79 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $6,760.83 | Professional | None | $2,290.87 | $2,630.27 | $6,760.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $7,943.28 | Professional | None | $1,949.84 | $2,630.27 | $7,943.28 |
8 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 $1,071.52 Median $1,148.15 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,071.52 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | 53 · Discontinued | $426.58 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,698.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,621.81 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $338.84 Typical High $371.54 | Professional | 55 · Aftercare only | $323.59 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 56 · Pre-op care only | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,584.89 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,715.35 Typical High $8,912.51 | Professional | 50 · Both sides | $2,951.21 | $3,715.35 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,548.82 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,258.93 | $1,548.82 | $3,715.35 |
Where California sits
The same service costs 11.2 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 $35,827MD $3,193
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.