How much rates vary
Facilitymedian $741 · 10th to 90th $617 to $1,862Professionalmedian $891 · 10th to 90th $692 to $1,349
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 $707.95 Median $891.25 Typical High $891.25 | Professional | None | $707.95 | $891.25 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,348.96 | Professional | None | $691.83 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,348.96 Typical High $2,041.74 | Professional | 50 · Both sides | $1,047.13 | $1,348.96 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,862.09 | Facility | None | $707.95 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,445.44 | Professional | None | $776.25 | $1,000.00 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,258.93 | Professional | None | $676.08 | $870.96 | $1,258.93 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | None | $741.31 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,174.90 | Professional | None | $660.69 | $870.96 | $1,174.90 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $616.60 |
Where Maine sits
The same service costs 3.6 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 $4,868DE $1,354
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.