How much rates vary
Facilitymedian $4,266 · 10th to 90th $525 to $14,125Professionalmedian $1,585 · 10th to 90th $1,288 to $2,570
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 $1,548.82 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,548.82 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,584.89 | $1,621.81 |
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 $1,513.56 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,819.70 | $3,311.31 |
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 $1,288.25 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,288.25 | $2,511.89 |
Hometown Health Setting Professional Modifier None Typical Low $10.72 Median $1,548.82 Typical High $2,454.71 | Professional | None | $10.72 | $1,548.82 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $2,187.76 | Professional | None | $9.33 | $9.33 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,265.80 | Facility | None | $1,445.44 | $1,445.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,148.15 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,584.89 | $2,454.71 |
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 $776.25 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $776.25 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,096.48 |
Where Nevada 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.