How much rates vary
Facilitymedian $1,202 · 10th to 90th $457 to $1,622Professionalmedian $490 · 10th to 90th $372 to $776
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $549.54 | Professional | None | $416.87 | $457.09 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $851.14 | Professional | None | $354.81 | $489.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,202.26 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $812.83 | Professional | None | $489.78 | $549.54 | $812.83 |
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 $380.19 Median $489.78 Typical High $724.44 | Professional | None | $380.19 | $489.78 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $549.54 | Professional | None | $416.87 | $457.09 | $549.54 |
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 $371.54 Median $537.03 Typical High $741.31 | Professional | None | $371.54 | $537.03 | $741.31 |
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 $218.78 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $87.10 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $323.59 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $45.71 |
Where Maine sits
The same service costs 5.0 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 $5,749MT $1,151
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.