How much rates vary
Facilitymedian $2,188 · 10th to 90th $871 to $3,890Professionalmedian $871 · 10th to 90th $676 to $1,318
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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,258.93 | Professional | None | $707.95 | $870.96 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,760.83 | Facility | None | $6,309.57 | $6,309.57 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | None | $676.08 | $891.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,318.26 Typical High $1,995.26 | Professional | 50 · Both sides | $1,023.29 | $1,318.26 | $1,995.26 |
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 $776.25 Median $954.99 Typical High $1,412.54 | Professional | None | $776.25 | $954.99 | $1,412.54 |
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 $676.08 Median $870.96 Typical High $1,230.27 | Professional | None | $676.08 | $870.96 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | None | $724.44 | $870.96 | $1,258.93 |
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 $660.69 Median $870.96 Typical High $1,174.90 | Professional | None | $660.69 | $870.96 | $1,174.90 |
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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $616.60 |
Where Maine sits
The same service costs 3.6 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 $7,904MT $2,218
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.