How much rates vary
Facilitymedian $4,266 · 10th to 90th $525 to $14,125Professionalmedian $2,344 · 10th to 90th $1,738 to $3,548
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 $2,238.72 Median $3,981.07 Typical High $10,715.19 | Facility | None | $2,238.72 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,290.87 | $2,344.23 | $2,344.23 |
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 $2,238.72 Median $2,570.40 Typical High $4,168.69 | Professional | None | $2,238.72 | $2,570.40 | $4,168.69 |
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 $1,737.80 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,737.80 | $1,905.46 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $15.85 Median $1,819.70 Typical High $3,311.31 | Professional | None | $15.85 | $1,819.70 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $3,162.28 | Professional | None | $12.02 | $12.02 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $4,265.80 | Facility | None | $2,089.30 | $2,089.30 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,089.30 | $5,495.41 |
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 $1,659.59 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,238.72 | $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 $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $1,621.81 |
Where Nevada 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.