How much rates vary
Facilitymedian $2,188 · 10th to 90th $282 to $3,715Professionalmedian $389 · 10th to 90th $204 to $1,259
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 $281.84 Median $281.84 Typical High $1,230.27 | Facility | None | $281.84 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $1,230.27 | Professional | None | $218.78 | $281.84 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $562.34 Typical High $1,380.38 | Professional | None | $173.78 | $562.34 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $3,715.35 | Facility | None | $707.95 | $2,818.38 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $1,445.44 | Professional | None | $251.19 | $398.11 | $1,445.44 |
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 $239.88 Median $363.08 Typical High $1,445.44 | Professional | None | $239.88 | $363.08 | $1,445.44 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $1,230.27 | Professional | None | $218.78 | $281.84 | $1,230.27 |
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 $263.03 Median $363.08 Typical High $1,258.93 | Professional | None | $263.03 | $363.08 | $1,258.93 |
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 $141.25 Median $141.25 Typical High $616.60 | Professional | 52 · Reduced service | $141.25 | $141.25 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $245.47 | Professional | 53 · Discontinued | $56.23 | $56.23 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $933.25 | Professional | 54 · Surgery only | $208.93 | $208.93 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $186.21 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $870.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $141.25 Typical High $616.60 | Professional | 52 · Reduced service | $141.25 | $141.25 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $245.47 | Professional | 53 · Discontinued | $56.23 | $56.23 | $245.47 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $933.25 | Professional | 54 · Surgery only | $208.93 | $208.93 | $933.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $186.21 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $123.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $870.96 |
Where Maine sits
The same service costs 5.1 times more in Colorado 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
CO $7,315MT $1,443
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.