How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $3,311Professionalmedian $562 · 10th to 90th $389 to $912
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 $501.19 Median $630.96 Typical High $812.83 | Professional | None | $501.19 | $630.96 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $660.69 | Professional | None | $323.59 | $478.63 | $660.69 |
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 $467.74 Median $660.69 Typical High $812.83 | Professional | None | $467.74 | $660.69 | $812.83 |
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 $398.11 Median $616.60 Typical High $1,023.29 | Professional | None | $398.11 | $616.60 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $812.83 | Professional | None | $501.19 | $630.96 | $812.83 |
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 $380.19 Median $616.60 Typical High $1,023.29 | Professional | None | $380.19 | $616.60 | $1,023.29 |
15 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 $251.19 Median $251.19 Typical High $407.38 | Professional | 52 · Reduced service | $251.19 | $251.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $602.56 | Professional | 54 · Surgery only | $380.19 | $380.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $120.23 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $724.44 Typical High $1,000.00 | Professional | 50 · Both sides | $501.19 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $77.62 Typical High $104.71 | Professional | 80 · Assistant surgeon | $53.70 | $77.62 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $67.61 Typical High $93.33 | Professional | AS · PA/NP assist | $46.77 | $67.61 | $93.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | 52 · Reduced service | $251.19 | $251.19 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $100.00 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $602.56 | Professional | 54 · Surgery only | $380.19 | $380.19 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $120.23 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $562.34 |
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 $6,451MT $1,460
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.