How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,399Professionalmedian $219 · 10th to 90th $138 to $372
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 $134.90 Median $223.87 Typical High $251.19 | Professional | None | $134.90 | $223.87 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $371.54 | Professional | None | $141.25 | $213.80 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,691.53 | Facility | None | $537.03 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $407.38 | Professional | None | $162.18 | $257.04 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $416.87 | Professional | None | $134.90 | $218.78 | $416.87 |
Martin's Point Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $239.88 | Professional | None | $138.04 | $223.87 | $239.88 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $354.81 | Professional | None | $114.82 | $204.17 | $354.81 |
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 $69.18 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $69.18 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $47.86 | Professional | 53 · Discontinued | $27.54 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $102.33 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $141.25 | $169.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $69.18 | $100.00 | $120.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $47.86 | Professional | 53 · Discontinued | $27.54 | $39.81 | $47.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $102.33 | $151.36 | $181.97 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $30.20 | $36.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $23.99 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $141.25 | $169.82 |
Where Maine sits
The same service costs 9.8 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 $4,589ND $469
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.