How much rates vary
Facilitymedian $13,183 · 10th to 90th $977 to $21,380Professionalmedian $2,512 · 10th to 90th $1,778 to $3,981
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 $1,778.28 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,778.28 | $1,778.28 | $1,862.09 |
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 $2,041.74 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,041.74 | $2,951.21 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,238.72 | $3,311.31 |
Denver HMP Setting Facility Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $4,265.80 | Facility | None | $1,778.28 | $2,238.72 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,290.87 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $3,467.37 Typical High $3,630.78 | Facility | None | $1,698.24 | $3,467.37 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,698.24 | $1,862.09 | $2,570.40 |
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 $1,862.09 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,398.83 | $3,715.35 |
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 $891.25 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,288.25 |
Where Colorado sits
The same service costs 14.4 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 $34,547MD $2,395
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.