How much rates vary
Facilitymedian $1,905 · 10th to 90th $813 to $3,311Professionalmedian $603 · 10th to 90th $468 to $912
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 $467.74 Median $602.56 Typical High $602.56 | Professional | None | $467.74 | $602.56 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | None | $467.74 | $616.60 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $2,951.21 | Facility | None | $812.83 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
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 $457.09 Median $588.84 Typical High $851.14 | Professional | None | $457.09 | $588.84 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | None | $467.74 | $602.56 | $602.56 |
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 $446.68 Median $588.84 Typical High $794.33 | Professional | None | $446.68 | $588.84 | $794.33 |
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 $239.88 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $416.87 |
Where Maine sits
The same service costs 4.6 times more in Alabama than in Montana. 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
AL $7,006MT $1,517
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.