How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $18,621Professionalmedian $1,950 · 10th to 90th $1,202 to $2,951
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $25,703.96 | Facility | None | $7,079.46 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,995.26 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $3,019.95 Typical High $3,801.89 | Professional | 50 · Both sides | $1,862.09 | $3,019.95 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,862.09 | $3,162.28 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,148.15 | $1,737.80 | $3,548.13 |
5 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 $630.96 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $954.99 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $169.82 | $169.82 |
Where Connecticut sits
The same service costs 17.6 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 $31,097MD $1,765
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.