How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,023 to $21,380Professionalmedian $2,630 · 10th to 90th $1,862 to $4,266
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 $6,025.60 Typical High $10,715.19 | Facility | None | $2,570.40 | $6,025.60 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,862.09 | $1,862.09 | $2,344.23 |
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 $2,187.76 Median $3,090.30 Typical High $4,570.88 | Professional | None | $2,187.76 | $3,090.30 | $4,570.88 |
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 $1,949.84 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,344.23 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $4,466.84 | Facility | None | $1,862.09 | $2,398.83 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,398.83 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,630.78 Typical High $3,801.89 | Facility | None | $1,778.28 | $3,630.78 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,778.28 | $1,995.26 | $2,691.53 |
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 $1,905.46 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,511.89 | $3,981.07 |
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 $933.25 Median $933.25 Typical High $977.24 | Professional | 52 · Reduced service | $933.25 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 53 · Discontinued | $371.54 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,348.96 |
Where Colorado sits
The same service costs 14.0 times more in Maine than in Texas. 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 $34,704TX $2,477
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.