How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,023 to $21,380Professionalmedian $3,162 · 10th to 90th $2,239 to $5,012
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 $2,238.72 Median $2,238.72 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,238.72 | $2,454.71 |
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 $2,570.40 Median $3,715.35 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,715.35 | $5,495.41 |
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 $2,290.87 Median $2,754.23 Typical High $3,981.07 | Professional | None | $2,290.87 | $2,754.23 | $3,981.07 |
Denver HMP Setting Facility Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $5,370.32 | Facility | None | $2,238.72 | $2,818.38 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,884.03 | $4,265.80 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $4,265.80 Typical High $4,466.84 | Facility | None | $2,137.96 | $4,265.80 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,344.23 | $3,235.94 |
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 $2,238.72 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,238.72 | $2,951.21 | $4,677.35 |
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 $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 53 · Discontinued | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,621.81 |
Where Colorado sits
The same service costs 13.8 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 $35,114TX $2,545
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.