How much rates vary
Facilitymedian $933 · 10th to 90th $240 to $3,467Professionalmedian $427 · 10th to 90th $214 to $891
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $239.88 Median $575.44 Typical High $3,467.37 | Facility | None | $239.88 | $575.44 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $758.58 | Professional | None | $229.09 | $338.84 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $912.01 | Professional | None | $213.80 | $467.74 | $912.01 |
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 $269.15 Median $457.09 Typical High $912.01 | Professional | None | $269.15 | $457.09 | $912.01 |
Community Health Options Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Community Health Options Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $389.05 | Professional | None | $223.87 | $316.23 | $389.05 |
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 $213.80 Median $457.09 Typical High $1,023.29 | Professional | None | $213.80 | $457.09 | $1,023.29 |
Martin's Point Setting Facility Modifier None Typical Low $218.78 Median $676.08 Typical High $3,467.37 | Facility | None | $218.78 | $676.08 | $3,467.37 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $758.58 | Professional | None | $229.09 | $338.84 | $758.58 |
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 $199.53 Median $436.52 Typical High $831.76 | Professional | None | $199.53 | $436.52 | $831.76 |
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 $117.49 Median $117.49 Typical High $288.40 | Professional | 52 · Reduced service | $117.49 | $117.49 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $114.82 | Professional | 53 · Discontinued | $46.77 | $47.86 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $436.52 | Professional | 54 · Surgery only | $177.83 | $177.83 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $87.10 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $57.54 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $57.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $288.40 | Professional | 52 · Reduced service | $117.49 | $117.49 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $114.82 | Professional | 53 · Discontinued | $47.86 | $47.86 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $436.52 | Professional | 54 · Surgery only | $177.83 | $177.83 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $87.10 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $57.54 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $57.54 |
Where Maine sits
The same service costs 4.1 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 $4,142MT $1,002
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.