How much rates vary
Facilitymedian $525 · 10th to 90th $457 to $1,413Professionalmedian $457 · 10th to 90th $347 to $708
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 $363.08 Median $436.52 Typical High $436.52 | Professional | None | $363.08 | $436.52 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | None | $363.08 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $707.95 Typical High $1,047.13 | Professional | 50 · Both sides | $549.54 | $707.95 | $1,047.13 |
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 $389.05 Median $501.19 Typical High $724.44 | Professional | None | $389.05 | $501.19 | $724.44 |
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 $323.59 Median $457.09 Typical High $707.95 | Professional | None | $323.59 | $457.09 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | None | $389.05 | $436.52 | $436.52 |
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 $295.12 Median $416.87 Typical High $588.84 | Professional | None | $295.12 | $416.87 | $588.84 |
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 $190.55 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $263.03 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $302.00 |
Where Maine sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.