How much rates vary
Facilitymedian $525 · 10th to 90th $182 to $708Professionalmedian $646 · 10th to 90th $490 to $977
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 $512.86 Median $630.96 Typical High $645.65 | Professional | None | $512.86 | $630.96 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $977.24 | Professional | None | $478.63 | $602.56 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | 50 · Both sides | $741.31 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $1,862.09 | Facility | None | $154.88 | $354.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,047.13 | Professional | None | $575.44 | $707.95 | $1,047.13 |
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 $489.78 Median $676.08 Typical High $1,047.13 | Professional | None | $489.78 | $676.08 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $645.65 | Professional | None | $512.86 | $630.96 | $645.65 |
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 $467.74 Median $630.96 Typical High $851.14 | Professional | None | $467.74 | $630.96 | $851.14 |
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 $257.04 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $446.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $125.89 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $446.68 | $467.74 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $64.57 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $446.68 |
Where Maine sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.