How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,000 to $21,380Professionalmedian $2,239 · 10th to 90th $1,514 to $3,388
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,479.11 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $15,135.61 Typical High $25,703.96 | Facility | None | $9,772.37 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,454.71 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,548.82 | $2,187.76 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,715.35 | Facility | None | $1,479.11 | $1,905.46 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,089.30 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $3,090.30 | Facility | None | $1,479.11 | $2,951.21 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,479.11 | $2,884.03 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,187.76 | $3,467.37 |
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 $741.31 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,230.27 |
Where Colorado sits
The same service costs 15.5 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 $34,449MD $2,222
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.