How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,236Professionalmedian $603 · 10th to 90th $427 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 $478.63 Median $512.86 Typical High $741.31 | Professional | None | $478.63 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | 50 · Both sides | $616.60 | $794.33 | $1,202.26 |
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 $537.03 Median $776.25 Typical High $933.25 | Professional | None | $537.03 | $776.25 | $933.25 |
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 $467.74 Median $676.08 Typical High $1,148.15 | Professional | None | $467.74 | $676.08 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $741.31 | Professional | None | $489.78 | $512.86 | $741.31 |
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 $407.38 Median $588.84 Typical High $977.24 | Professional | None | $407.38 | $588.84 | $977.24 |
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 $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $512.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $257.04 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $102.33 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $389.05 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $74.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $512.86 |
Where Maine sits
The same service costs 4.4 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 $6,491MT $1,489
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.