How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,096 to $21,380Professionalmedian $2,188 · 10th to 90th $1,549 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 $2,570.40 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 $1,548.82 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,548.82 | $2,398.83 |
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 $1,778.28 Median $2,570.40 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,570.40 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $6,760.83 | Facility | None | $1,479.11 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,584.89 | $1,949.84 | $2,884.03 |
Denver HMP Setting Facility Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,890.45 | Facility | None | $1,548.82 | $1,995.26 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,089.30 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,090.30 Typical High $3,235.94 | Facility | None | $1,548.82 | $3,090.30 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,659.59 | $2,344.23 |
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 $1,584.89 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,089.30 | $3,311.31 |
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 $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,122.02 |
Where Colorado sits
The same service costs 15.3 times more in Maine than in Delaware. 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 $34,309DE $2,240
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.