How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,622Professionalmedian $240 · 10th to 90th $182 to $355
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 $208.93 Median $218.78 Typical High $218.78 | Professional | None | $208.93 | $218.78 | $218.78 |
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 $173.78 Median $251.19 Typical High $363.08 | Professional | None | $173.78 | $251.19 | $363.08 |
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 $234.42 Median $263.03 Typical High $407.38 | Professional | None | $234.42 | $263.03 | $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 $186.21 Median $239.88 Typical High $354.81 | Professional | None | $186.21 | $239.88 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | None | $208.93 | $218.78 | $218.78 |
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 $177.83 Median $257.04 Typical High $354.81 | Professional | None | $177.83 | $257.04 | $354.81 |
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 $104.71 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $158.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $158.49 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $33.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $21.88 |
Where Maine sits
The same service costs 7.3 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 $4,136MT $564
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.