How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $1,585Professionalmedian $309 · 10th to 90th $145 to $631
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 $151.36 Median $165.96 Typical High $436.52 | Professional | None | $151.36 | $165.96 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $309.03 Typical High $691.83 | Professional | None | $147.91 | $309.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,621.81 | Facility | None | $537.03 | $1,202.26 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $707.95 | Professional | None | $177.83 | $363.08 | $707.95 |
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 $144.54 Median $338.84 Typical High $776.25 | Professional | None | $144.54 | $338.84 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $436.52 | Professional | None | $154.88 | $158.49 | $436.52 |
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 $131.83 Median $302.00 Typical High $630.96 | Professional | None | $131.83 | $302.00 | $630.96 |
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 $77.62 Median $79.43 Typical High $218.78 | Professional | 52 · Reduced service | $77.62 | $79.43 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $87.10 | Professional | 53 · Discontinued | $31.62 | $31.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $323.59 | Professional | 54 · Surgery only | $117.49 | $120.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $64.57 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $43.65 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $79.43 Typical High $218.78 | Professional | 52 · Reduced service | $77.62 | $79.43 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $87.10 | Professional | 53 · Discontinued | $31.62 | $31.62 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $323.59 | Professional | 54 · Surgery only | $117.49 | $120.23 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $64.57 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $43.65 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $43.65 |
Where Maine sits
The same service costs 5.7 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 $4,090MT $722
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.