How much rates vary
Facilitymedian $1,698 · 10th to 90th $224 to $2,818Professionalmedian $631 · 10th to 90th $200 to $1,318
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 $223.87 Median $223.87 Typical High $933.25 | Facility | None | $223.87 | $223.87 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $758.58 Typical High $1,174.90 | Professional | None | $223.87 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $549.54 Typical High $1,318.26 | Professional | None | $165.96 | $549.54 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $3,090.30 | Facility | None | $707.95 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $870.96 Typical High $1,621.81 | Professional | None | $234.42 | $870.96 | $1,621.81 |
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 $190.55 Median $457.09 Typical High $1,380.38 | Professional | None | $190.55 | $457.09 | $1,380.38 |
Martin's Point Setting Professional Modifier None Typical Low $223.87 Median $758.58 Typical High $1,174.90 | Professional | None | $223.87 | $758.58 | $1,174.90 |
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 $239.88 Median $457.09 Typical High $1,288.25 | Professional | None | $239.88 | $457.09 | $1,288.25 |
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 $112.20 Median $151.36 Typical High $467.74 | Professional | 52 · Reduced service | $112.20 | $151.36 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $186.21 | Professional | 53 · Discontinued | $44.67 | $60.26 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $707.95 | Professional | 54 · Surgery only | $169.82 | $223.87 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $141.25 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $93.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $151.36 Typical High $467.74 | Professional | 52 · Reduced service | $112.20 | $151.36 | $467.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $186.21 | Professional | 53 · Discontinued | $44.67 | $60.26 | $186.21 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $707.95 | Professional | 54 · Surgery only | $169.82 | $223.87 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $141.25 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $93.33 |
Where Maine sits
The same service costs 4.0 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 $5,041MT $1,267
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.