How much rates vary
Facilitymedian $7,413 · 10th to 90th $631 to $61,660Professionalmedian $3,090 · 10th to 90th $2,042 to $16,982
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 $2,398.83 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,398.83 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,290.87 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $14,454.40 Typical High $28,840.32 | Facility | None | $8,511.38 | $14,454.40 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $9,120.11 | Professional | None | $2,691.53 | $3,311.31 | $9,120.11 |
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 $1,698.24 Median $2,398.83 Typical High $5,888.44 | Professional | None | $1,698.24 | $2,398.83 | $5,888.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,630.27 | $2,754.23 |
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 $2,238.72 Median $2,511.89 Typical High $6,309.57 | Professional | None | $2,238.72 | $2,511.89 | $6,309.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,445.44 | $2,454.71 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $5,623.41 | Professional | None | $2,187.76 | $2,754.23 | $5,623.41 |
Lucent Health Setting Professional Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $19,054.61 | Professional | None | $16,982.44 | $16,982.44 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $2,238.72 Median $2,511.89 Typical High $6,456.54 | Professional | None | $2,238.72 | $2,511.89 | $6,456.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $1,862.09 Median $2,511.89 Typical High $7,585.78 | Professional | None | $1,862.09 | $2,511.89 | $7,585.78 |
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 $1,023.29 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,023.29 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $407.38 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $323.59 Typical High $354.81 | Professional | 55 · Aftercare only | $309.03 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,513.56 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,548.13 Typical High $8,511.38 | Professional | 50 · Both sides | $2,818.38 | $3,548.13 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,479.11 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,174.90 | $1,479.11 | $3,548.13 |
Where California sits
The same service costs 11.6 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 $35,595MD $3,074
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.