How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $4,467Professionalmedian $550 · 10th to 90th $389 to $813
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 $446.68 Median $524.81 Typical High $549.54 | Professional | None | $446.68 | $524.81 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $812.83 | Professional | None | $338.84 | $501.19 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $776.25 Typical High $1,230.27 | Professional | 50 · Both sides | $501.19 | $776.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $3,019.95 Typical High $4,897.79 | Facility | None | $537.03 | $3,019.95 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $812.83 | Professional | None | $467.74 | $588.84 | $812.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $851.14 | Professional | None | $389.05 | $588.84 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | None | $446.68 | $446.68 | $549.54 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $812.83 | Professional | None | $436.52 | $602.56 | $812.83 |
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 $223.87 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $91.20 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $338.84 | $407.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $81.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $54.95 |
Where Maine sits
The same service costs 6.3 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 $7,350MT $1,166
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.