How much rates vary
Facilitymedian $6,310 · 10th to 90th $955 to $12,589Professionalmedian $1,445 · 10th to 90th $977 to $2,291
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 $954.99 Median $954.99 Typical High $2,570.40 | Professional | None | $954.99 | $954.99 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,584.89 | $2,344.23 |
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 $1,023.29 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,412.54 | $1,905.46 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,398.83 | Facility | None | $954.99 | $1,258.93 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $1,995.26 | Facility | None | $954.99 | $1,905.46 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,862.09 | Professional | None | $676.08 | $954.99 | $1,862.09 |
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 $1,148.15 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,412.54 | $2,238.72 |
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 $478.63 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $794.33 |
Where Colorado sits
The same service costs 9.8 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 $16,204MD $1,659
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.