How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,692Professionalmedian $759 · 10th to 90th $603 to $1,230
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 $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,230.27 | Professional | None | $616.60 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $501.19 Typical High $776.25 | Professional | 62 · Two surgeons | $389.05 | $501.19 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $2,951.21 | Facility | None | $537.03 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,318.26 | Professional | None | $724.44 | $912.01 | $1,318.26 |
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 $575.44 Median $758.58 Typical High $1,174.90 | Professional | None | $575.44 | $758.58 | $1,174.90 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
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 $537.03 Median $724.44 Typical High $1,023.29 | Professional | None | $537.03 | $724.44 | $1,023.29 |
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 $323.59 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Maine sits
The same service costs 5.0 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 $6,515DE $1,300
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.