How much rates vary
Facilitymedian $525 · 10th to 90th $457 to $1,413Professionalmedian $589 · 10th to 90th $427 to $832
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 $446.68 Median $524.81 Typical High $588.84 | Professional | None | $446.68 | $524.81 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $831.76 | Professional | None | $426.58 | $537.03 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $1,258.93 | Professional | 50 · Both sides | $645.65 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $1,584.89 | Facility | None | $537.03 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $954.99 | Professional | None | $467.74 | $660.69 | $954.99 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,000.00 | Professional | None | $416.87 | $588.84 | $1,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $588.84 | Professional | None | $467.74 | $524.81 | $588.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $741.31 | Professional | None | $398.11 | $524.81 | $741.31 |
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 $229.09 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $407.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $263.03 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $104.71 | $117.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $398.11 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $58.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $407.38 |
Where Maine sits
The same service costs 5.3 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 $4,377FL $831
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.