How much rates vary
Facilitymedian $933 · 10th to 90th $126 to $2,291Professionalmedian $447 · 10th to 90th $145 to $933
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 $125.89 Median $489.78 Typical High $489.78 | Facility | None | $125.89 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $489.78 Typical High $776.25 | Professional | None | $125.89 | $489.78 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $354.81 Typical High $912.01 | Professional | None | $144.54 | $354.81 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $537.03 Typical High $1,348.96 | Professional | 50 · Both sides | $239.88 | $537.03 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,290.87 | Facility | None | $707.95 | $1,000.00 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $616.60 Typical High $1,047.13 | Professional | None | $223.87 | $616.60 | $1,047.13 |
Community Health Options Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $524.81 Typical High $1,000.00 | Professional | None | $162.18 | $524.81 | $1,000.00 |
Martin's Point Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $67,608.30 | Facility | None | $18,197.01 | $18,197.01 | $67,608.30 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $489.78 Typical High $776.25 | Professional | None | $125.89 | $489.78 | $776.25 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $1,096.48 | Professional | None | $213.80 | $426.58 | $1,096.48 |
10 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 $63.10 Median $79.43 Typical High $245.47 | Professional | 52 · Reduced service | $63.10 | $79.43 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $31.62 Typical High $97.72 | Professional | 53 · Discontinued | $25.12 | $31.62 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $120.23 Typical High $363.08 | Professional | 54 · Surgery only | $95.50 | $120.23 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $72.44 | Professional | 55 · Aftercare only | $19.05 | $23.99 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.85 Typical High $48.98 | Professional | 56 · Pre-op care only | $12.59 | $15.85 | $48.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $79.43 Typical High $245.47 | Professional | 52 · Reduced service | $63.10 | $79.43 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $31.62 Typical High $97.72 | Professional | 53 · Discontinued | $25.12 | $31.62 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $120.23 Typical High $363.08 | Professional | 54 · Surgery only | $95.50 | $120.23 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $72.44 | Professional | 55 · Aftercare only | $19.05 | $23.99 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.85 Typical High $48.98 | Professional | 56 · Pre-op care only | $12.59 | $15.85 | $48.98 |
Where Maine sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.