How much rates vary
Facilitymedian $692 · 10th to 90th $91 to $1,380Professionalmedian $219 · 10th to 90th $87 to $501
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 $91.20 Median $91.20 Typical High $309.03 | Facility | None | $91.20 | $91.20 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $501.19 | Professional | None | $91.20 | $138.04 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $229.09 Typical High $489.78 | Professional | None | $87.10 | $229.09 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $676.08 Typical High $2,290.87 | Facility | None | $302.00 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $512.86 | Professional | None | $102.33 | $229.09 | $512.86 |
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 $87.10 Median $223.87 Typical High $575.44 | Professional | None | $87.10 | $223.87 | $575.44 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $501.19 | Professional | None | $91.20 | $138.04 | $501.19 |
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 $75.86 Median $204.17 Typical High $398.11 | Professional | None | $75.86 | $204.17 | $398.11 |
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 $44.67 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $44.67 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $17.78 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $66.07 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $30.20 Typical High $46.77 | Professional | 55 · Aftercare only | $13.18 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $8.91 | $19.95 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $45.71 | $100.00 | $154.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $18.20 | $39.81 | $61.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $67.61 | $147.91 | $234.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $30.20 Typical High $46.77 | Professional | 55 · Aftercare only | $13.49 | $30.20 | $46.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $9.12 | $19.95 | $30.90 |
Where Maine sits
The same service costs 9.0 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 $4,579MT $507
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.