How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,236Professionalmedian $562 · 10th to 90th $417 to $871
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 $457.09 Median $645.65 Typical High $831.76 | Professional | None | $457.09 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $758.58 | Professional | None | $371.54 | $524.81 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $2,238.72 | Facility | None | $707.95 | $1,698.24 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $870.96 | Professional | None | $512.86 | $707.95 | $870.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,047.13 | Professional | None | $436.52 | $645.65 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $831.76 | Professional | None | $457.09 | $645.65 | $831.76 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $891.25 | Professional | None | $389.05 | $537.03 | $891.25 |
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 $245.47 Median $245.47 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $371.54 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $794.33 Typical High $1,122.02 | Professional | 50 · Both sides | $575.44 | $794.33 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $245.47 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $97.72 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $371.54 | $371.54 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $67.61 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $478.63 |
Where Maine sits
The same service costs 4.7 times more in Colorado than in Montana. 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 $6,464MT $1,390
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.