How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $389 · 10th to 90th $288 to $575
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 $288.40 Median $354.81 Typical High $407.38 | Professional | None | $288.40 | $354.81 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $562.34 | Professional | None | $288.40 | $371.54 | $562.34 |
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 $338.84 Median $436.52 Typical High $645.65 | Professional | None | $338.84 | $436.52 | $645.65 |
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 $288.40 Median $416.87 Typical High $676.08 | Professional | None | $288.40 | $416.87 | $676.08 |
Martin's Point Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | None | $295.12 | $354.81 | $426.58 |
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 $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
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 $154.88 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $154.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $61.66 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $234.42 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $218.78 | $251.19 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $575.44 Typical High $851.14 | Professional | 50 · Both sides | $436.52 | $575.44 | $851.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $177.83 | $194.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $70.79 | $77.62 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $269.15 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $38.90 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $275.42 |
Where Maine sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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 $3,149MD $483
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.