How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $603 · 10th to 90th $447 to $891
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 $467.74 Median $562.34 Typical High $602.56 | Professional | None | $467.74 | $562.34 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $891.25 | Professional | None | $457.09 | $575.44 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | 50 · Both sides | $676.08 | $891.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $1,412.54 | Facility | None | $154.88 | $354.81 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,000.00 | Professional | None | $524.81 | $676.08 | $1,000.00 |
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 $446.68 Median $645.65 Typical High $1,023.29 | Professional | None | $446.68 | $645.65 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | None | $489.78 | $562.34 | $602.56 |
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 $407.38 Median $575.44 Typical High $794.33 | Professional | None | $407.38 | $575.44 | $794.33 |
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 $245.47 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $426.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $281.84 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $112.20 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $426.58 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $60.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $426.58 |
Where Maine sits
The same service costs 4.9 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 $3,107FL $640
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.