How much rates vary
Facilitymedian $1,072 · 10th to 90th $240 to $1,585Professionalmedian $631 · 10th to 90th $209 to $1,445
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 $239.88 Median $239.88 Typical High $1,071.52 | Facility | None | $239.88 | $239.88 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $1,071.52 | Professional | None | $234.42 | $512.86 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $630.96 Typical High $1,412.54 | Professional | None | $208.93 | $630.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $5,754.40 | Facility | None | $707.95 | $1,000.00 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $562.34 Typical High $1,584.89 | Professional | None | $269.15 | $562.34 | $1,584.89 |
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 $204.17 Median $707.95 Typical High $1,584.89 | Professional | None | $204.17 | $707.95 | $1,584.89 |
Martin's Point Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $1,071.52 | Professional | None | $234.42 | $512.86 | $1,071.52 |
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 $204.17 Median $660.69 Typical High $1,479.11 | Professional | None | $204.17 | $660.69 | $1,479.11 |
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 $120.23 Median $138.04 Typical High $537.03 | Professional | 52 · Reduced service | $120.23 | $138.04 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $213.80 | Professional | 53 · Discontinued | $47.86 | $54.95 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $204.17 Typical High $812.83 | Professional | 54 · Surgery only | $177.83 | $204.17 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $162.18 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $107.15 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $537.03 | Professional | 52 · Reduced service | $120.23 | $138.04 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $213.80 | Professional | 53 · Discontinued | $47.86 | $54.95 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $812.83 | Professional | 54 · Surgery only | $181.97 | $204.17 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $162.18 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $107.15 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $107.15 |
Where Maine sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $977
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.