How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $12,589Professionalmedian $1,820 · 10th to 90th $501 to $10,715
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 $549.54 Median $616.60 Typical High $8,317.64 | Professional | None | $549.54 | $616.60 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $1,819.70 Typical High $10,000.00 | Professional | None | $501.19 | $1,819.70 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $8,511.38 Typical High $13,803.84 | Facility | None | $707.95 | $8,511.38 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $10,964.78 | Professional | None | $616.60 | $1,047.13 | $10,964.78 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $4,897.79 Typical High $11,220.18 | Professional | None | $501.19 | $4,897.79 | $11,220.18 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $8,317.64 | Professional | None | $549.54 | $616.60 | $8,317.64 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,819.70 Typical High $12,302.69 | Professional | None | $467.74 | $1,819.70 | $12,302.69 |
12 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 $275.42 Median $309.03 Typical High $4,168.69 | Professional | 52 · Reduced service | $275.42 | $309.03 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $1,659.59 | Professional | 53 · Discontinued | $109.65 | $123.03 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $6,309.57 | Professional | 54 · Surgery only | $416.87 | $457.09 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $1,258.93 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $831.76 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $5,888.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $309.03 Typical High $4,168.69 | Professional | 52 · Reduced service | $275.42 | $309.03 | $4,168.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $1,659.59 | Professional | 53 · Discontinued | $109.65 | $123.03 | $1,659.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $6,309.57 | Professional | 54 · Surgery only | $416.87 | $457.09 | $6,309.57 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $1,258.93 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $1,258.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $831.76 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $831.76 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $5,888.44 |
Where Maine sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.