How much rates vary
Facilitymedian $1,445 · 10th to 90th $347 to $3,311Professionalmedian $676 · 10th to 90th $398 to $1,175
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $346.74 Median $478.63 Typical High $478.63 | Facility | None | $346.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $1,122.02 | Professional | None | $346.74 | $478.63 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,174.90 | Professional | None | $457.09 | $676.08 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $2,290.87 | Facility | None | $812.83 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,258.93 | Professional | None | $588.84 | $851.14 | $1,258.93 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,258.93 | Professional | None | $549.54 | $758.58 | $1,258.93 |
Martin's Point Setting Facility Modifier None Typical Low $60,255.96 Median $60,255.96 Typical High $97,723.72 | Facility | None | $60,255.96 | $60,255.96 | $97,723.72 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $1,122.02 | Professional | None | $346.74 | $478.63 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,023.29 | Professional | None | $549.54 | $724.44 | $1,023.29 |
12 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 $173.78 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $91.20 | $95.50 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $346.74 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $47.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $338.84 |
Where Maine sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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
CO $6,580WV $1,277
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.