How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,585Professionalmedian $661 · 10th to 90th $513 to $1,023
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $977.24 | Professional | None | $524.81 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | None | $524.81 | $676.08 | $1,023.29 |
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 $562.34 Median $741.31 Typical High $1,071.52 | Professional | None | $562.34 | $741.31 | $1,071.52 |
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 $512.86 Median $660.69 Typical High $954.99 | Professional | None | $512.86 | $660.69 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $977.24 | Professional | None | $537.03 | $660.69 | $977.24 |
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 $457.09 Median $660.69 Typical High $891.25 | Professional | None | $457.09 | $660.69 | $891.25 |
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 $269.15 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $467.74 |
Where Maine sits
The same service costs 4.0 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 $5,106MD $1,261
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.