How much rates vary
Facilitymedian $372 · 10th to 90th $200 to $692Professionalmedian $347 · 10th to 90th $257 to $468
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 $331.13 Median $331.13 Typical High $371.54 | Facility | None | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $371.54 | Professional | None | $295.12 | $331.13 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $446.68 | Professional | None | $223.87 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $239.88 Typical High $707.95 | Facility | None | $56.23 | $239.88 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $537.03 | Professional | None | $295.12 | $389.05 | $537.03 |
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 $263.03 Median $323.59 Typical High $489.78 | Professional | None | $263.03 | $323.59 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | None | $316.23 | $331.13 | $371.54 |
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 $251.19 Median $354.81 Typical High $489.78 | Professional | None | $251.19 | $354.81 | $489.78 |
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 $144.54 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $245.47 Typical High $275.42 | Professional | 54 · Surgery only | $218.78 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $43.65 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $158.49 | $165.96 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $66.07 | $74.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $275.42 | Professional | 54 · Surgery only | $234.42 | $245.47 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $37.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $257.04 |
Where Maine sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.