How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $813 · 10th to 90th $646 to $1,288
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,047.13 | Professional | None | $616.60 | $812.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,288.25 | Professional | None | $645.65 | $851.14 | $1,288.25 |
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 $758.58 Median $954.99 Typical High $1,412.54 | Professional | None | $758.58 | $954.99 | $1,412.54 |
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 $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,047.13 | Professional | None | $645.65 | $812.83 | $1,047.13 |
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 $588.84 Median $776.25 Typical High $1,096.48 | Professional | None | $588.84 | $776.25 | $1,096.48 |
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 $338.84 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $398.11 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Maine sits
The same service costs 4.3 times more in Alaska than in West Virginia. 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
AK $6,645WV $1,559
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.