How much rates vary
Facilitymedian $2,239 · 10th to 90th $708 to $2,951Professionalmedian $832 · 10th to 90th $646 to $1,259
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 Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | None | $645.65 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Professional | None | $645.65 | $851.14 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | 50 · Both sides | $977.24 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,951.21 | Facility | None | $707.95 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,380.38 | Professional | None | $741.31 | $912.01 | $1,380.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,174.90 | Professional | None | $645.65 | $831.76 | $1,174.90 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | None | $660.69 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,122.02 | Professional | None | $630.96 | $831.76 | $1,122.02 |
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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $588.84 |
Where Maine sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.