How much rates vary
Facilitymedian $741 · 10th to 90th $282 to $4,266Professionalmedian $186 · 10th to 90th $98 to $389
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 $89.13 Median $281.84 Typical High $33,884.42 | Facility | None | $89.13 | $281.84 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $389.05 | Professional | None | $109.65 | $128.82 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $389.05 | Professional | None | $79.43 | $177.83 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,187.76 Typical High $2,951.21 | Facility | None | $537.03 | $2,187.76 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $398.11 | Professional | None | $120.23 | $186.21 | $398.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $426.58 | Professional | None | $114.82 | $223.87 | $426.58 |
Martin's Point Setting Facility Modifier None Typical Low $89.13 Median $281.84 Typical High $33,884.42 | Facility | None | $89.13 | $281.84 | $33,884.42 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $389.05 | Professional | None | $109.65 | $131.83 | $389.05 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $389.05 | Professional | None | $138.04 | $223.87 | $389.05 |
10 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 $64.57 Median $66.07 Typical High $162.18 | Professional | 52 · Reduced service | $64.57 | $66.07 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $64.57 | Professional | 53 · Discontinued | $25.70 | $26.30 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $97.72 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $32.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $66.07 Typical High $162.18 | Professional | 52 · Reduced service | $64.57 | $66.07 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $64.57 | Professional | 53 · Discontinued | $25.70 | $26.30 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $97.72 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $48.98 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $32.36 |
Where Maine sits
The same service costs 10.4 times more in Colorado than in North Dakota. 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 $4,594ND $443
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.