How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $661 · 10th to 90th $490 to $1,023
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 $616.60 Median $660.69 Typical High $1,023.29 | Professional | None | $616.60 | $660.69 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $933.25 | Professional | None | $467.74 | $630.96 | $933.25 |
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 $549.54 Median $724.44 Typical High $1,047.13 | Professional | None | $549.54 | $724.44 | $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 $691.83 Typical High $1,174.90 | Professional | None | $489.78 | $691.83 | $1,174.90 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,023.29 | Professional | None | $616.60 | $660.69 | $1,023.29 |
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 $446.68 Median $630.96 Typical High $851.14 | Professional | None | $446.68 | $630.96 | $851.14 |
13 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 $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | 50 · Both sides | $707.95 | $933.25 | $1,380.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $123.03 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $457.09 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $66.07 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $467.74 |
Where Maine sits
The same service costs 5.2 times more in Connecticut 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
CT $3,468DE $666
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.