How much rates vary
Facilitymedian $4,266 · 10th to 90th $525 to $14,125Professionalmedian $2,455 · 10th to 90th $1,995 to $3,981
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 $2,238.72 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,238.72 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,398.83 | $2,454.71 | $2,454.71 |
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 $2,398.83 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,398.83 | $2,884.03 | $5,011.87 |
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 $1,995.26 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,995.26 | $1,995.26 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $27.54 Median $2,454.71 Typical High $3,630.78 | Professional | None | $27.54 | $2,454.71 | $3,630.78 |
Hometown Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $3,235.94 | Professional | None | $23.44 | $23.44 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Facility | None | $2,137.96 | $2,137.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,995.26 Median $2,511.89 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,511.89 | $3,715.35 |
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 $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,202.26 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Where Nevada 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.