How much rates vary
Facilitymedian $501 · 10th to 90th $219 to $708Professionalmedian $513 · 10th to 90th $380 to $871
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $891.25 | Professional | None | $407.38 | $478.63 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $758.58 Typical High $1,148.15 | Professional | 50 · Both sides | $588.84 | $758.58 | $1,148.15 |
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 $407.38 Median $537.03 Typical High $776.25 | Professional | None | $407.38 | $537.03 | $776.25 |
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 $363.08 Median $562.34 Typical High $870.96 | Professional | None | $363.08 | $562.34 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $891.25 | Professional | None | $478.63 | $478.63 | $891.25 |
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 $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
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 $199.53 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $331.13 |
Where Maine sits
The same service costs 6.4 times more in Connecticut than in Texas. 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 $3,322TX $515
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.