How much rates vary
Facilitymedian $692 · 10th to 90th $646 to $1,202Professionalmedian $692 · 10th to 90th $525 to $1,072
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 $645.65 Median $676.08 Typical High $691.83 | Facility | None | $645.65 | $676.08 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,071.52 | Professional | None | $575.44 | $691.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,000.00 | Professional | None | $512.86 | $660.69 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,290.87 | Facility | None | $812.83 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | None | $630.96 | $776.25 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,202.26 | Professional | None | $512.86 | $758.58 | $1,202.26 |
Martin's Point Setting Facility Modifier None Typical Low $630.96 Median $676.08 Typical High $776.25 | Facility | None | $630.96 | $676.08 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,096.48 | Professional | None | $616.60 | $691.83 | $1,096.48 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $912.01 | Professional | None | $489.78 | $676.08 | $912.01 |
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 $288.40 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,000.00 Typical High $1,513.56 | Professional | 50 · Both sides | $776.25 | $1,000.00 | $1,513.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $323.59 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $128.82 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $489.78 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $69.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $478.63 |
Where Maine sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.