How much rates vary
Facilitymedian $708 · 10th to 90th $501 to $1,413Professionalmedian $550 · 10th to 90th $407 to $813
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 $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $812.83 | Professional | None | $436.52 | $549.54 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | None | $407.38 | $512.86 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $1,584.89 | Facility | None | $537.03 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $891.25 | Professional | None | $478.63 | $616.60 | $891.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $933.25 | Professional | None | $407.38 | $575.44 | $933.25 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $812.83 | Professional | None | $457.09 | $549.54 | $812.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $707.95 | Professional | None | $371.54 | $524.81 | $707.95 |
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 $213.80 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $213.80 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $323.59 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $380.19 |
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 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $251.19 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $100.00 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $380.19 | $407.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $81.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $54.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $380.19 |
Where Maine sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.