How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $575 · 10th to 90th $447 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 Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $870.96 | Professional | None | $478.63 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $891.25 | Professional | None | $457.09 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | 50 · Both sides | $676.08 | $891.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $2,951.21 | Facility | None | $812.83 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | None | $512.86 | $630.96 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | None | $436.52 | $562.34 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $758.58 | Professional | None | $426.58 | $562.34 | $758.58 |
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 $234.42 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $398.11 |
Where Maine sits
The same service costs 4.9 times more in Wisconsin than in Montana. 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
WI $7,341MT $1,483
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.