How much rates vary
Facilitymedian $525 · 10th to 90th $182 to $708Professionalmedian $490 · 10th to 90th $372 to $794
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 $389.05 Median $446.68 Typical High $489.78 | Professional | None | $389.05 | $446.68 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $794.33 | Professional | None | $380.19 | $512.86 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $794.33 Typical High $1,202.26 | Professional | 50 · Both sides | $562.34 | $794.33 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $1,862.09 | Facility | None | $154.88 | $354.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $891.25 | Professional | None | $467.74 | $549.54 | $891.25 |
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 $354.81 Median $537.03 Typical High $933.25 | Professional | None | $354.81 | $537.03 | $933.25 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $489.78 | Professional | None | $416.87 | $446.68 | $489.78 |
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 $338.84 Median $467.74 Typical High $660.69 | Professional | None | $338.84 | $467.74 | $660.69 |
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 $208.93 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $346.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $223.87 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $89.13 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $331.13 | $331.13 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $48.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $346.74 |
Where Maine sits
The same service costs 5.3 times more in New York 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
NY $3,063DE $576
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.