How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,862Professionalmedian $501 · 10th to 90th $331 to $776
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 Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | None | $389.05 | $630.96 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | None | $323.59 | $446.68 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,862.09 | Facility | None | $707.95 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $776.25 | Professional | None | $407.38 | $645.65 | $776.25 |
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 $331.13 Median $562.34 Typical High $1,047.13 | Professional | None | $331.13 | $562.34 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | None | $398.11 | $630.96 | $630.96 |
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 $316.23 Median $478.63 Typical High $776.25 | Professional | None | $316.23 | $478.63 | $776.25 |
13 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 $204.17 Median $204.17 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $676.08 Typical High $954.99 | Professional | 50 · Both sides | $489.78 | $676.08 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $204.17 | $316.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $83.18 | $125.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $309.03 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $63.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $446.68 |
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.