How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $537 · 10th to 90th $417 to $871
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 $407.38 Median $524.81 Typical High $524.81 | Professional | None | $407.38 | $524.81 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $870.96 | Professional | None | $426.58 | $575.44 | $870.96 |
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 $501.19 Median $660.69 Typical High $954.99 | Professional | None | $501.19 | $660.69 | $954.99 |
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 $398.11 Median $549.54 Typical High $870.96 | Professional | None | $398.11 | $549.54 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | None | $407.38 | $524.81 | $524.81 |
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 $371.54 Median $501.19 Typical High $691.83 | Professional | None | $371.54 | $501.19 | $691.83 |
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 $263.03 | Professional | 52 · Reduced service | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Where Maine sits
The same service costs 4.2 times more in Colorado than in Delaware. 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 $4,996DE $1,192
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.