How much rates vary
Facilitymedian $1,202 · 10th to 90th $204 to $1,622Professionalmedian $389 · 10th to 90th $191 to $759
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 $177.83 Median $204.17 Typical High $588.84 | Facility | None | $177.83 | $204.17 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $524.81 | Professional | None | $199.53 | $239.88 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $831.76 | Professional | None | $190.55 | $389.05 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,862.09 | Facility | None | $707.95 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $851.14 | Professional | None | $229.09 | $407.38 | $851.14 |
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 $190.55 Median $407.38 Typical High $912.01 | Professional | None | $190.55 | $407.38 | $912.01 |
Martin's Point Setting Facility Modifier None Typical Low $177.83 Median $204.17 Typical High $588.84 | Facility | None | $177.83 | $204.17 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $524.81 | Professional | None | $204.17 | $239.88 | $524.81 |
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 $173.78 Median $380.19 Typical High $758.58 | Professional | None | $173.78 | $380.19 | $758.58 |
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 $102.33 Median $102.33 Typical High $263.03 | Professional | 52 · Reduced service | $102.33 | $102.33 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $104.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $154.88 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $52.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $263.03 | Professional | 52 · Reduced service | $102.33 | $102.33 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $104.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $154.88 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $52.48 |
Where Maine sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.