How much rates vary
Facilitymedian $501 · 10th to 90th $151 to $708Professionalmedian $398 · 10th to 90th $288 to $589
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 $309.03 Median $407.38 Typical High $588.84 | Professional | None | $309.03 | $407.38 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $549.54 | Professional | None | $281.84 | $380.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $218.78 Typical High $707.95 | Facility | None | $56.23 | $218.78 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $645.65 | Professional | None | $338.84 | $436.52 | $645.65 |
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 $275.42 Median $416.87 Typical High $707.95 | Professional | None | $275.42 | $416.87 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $588.84 | Professional | None | $338.84 | $407.38 | $588.84 |
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 $263.03 Median $371.54 Typical High $524.81 | Professional | None | $263.03 | $371.54 | $524.81 |
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 $158.49 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $239.88 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $173.78 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $69.18 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $257.04 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $39.81 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $281.84 |
Where Maine sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.