How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,862Professionalmedian $692 · 10th to 90th $490 to $977
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 $512.86 Median $630.96 Typical High $776.25 | Professional | None | $512.86 | $630.96 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $954.99 | Professional | None | $478.63 | $616.60 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,862.09 | Facility | None | $707.95 | $1,174.90 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,122.02 | Professional | None | $575.44 | $758.58 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,148.15 | Professional | None | $501.19 | $707.95 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $776.25 | Professional | None | $512.86 | $645.65 | $776.25 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $912.01 | Professional | None | $467.74 | $660.69 | $912.01 |
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 $275.42 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | 50 · Both sides | $741.31 | $977.24 | $1,445.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $309.03 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $125.89 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $467.74 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $69.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $478.63 |
Where Maine sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.