How much rates vary
Facilitymedian $1,698 · 10th to 90th $263 to $2,818Professionalmedian $661 · 10th to 90th $229 to $1,380
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 $263.03 Median $263.03 Typical High $977.24 | Facility | None | $263.03 | $263.03 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $794.33 Typical High $1,230.27 | Professional | None | $245.47 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $575.44 Typical High $1,380.38 | Professional | None | $194.98 | $575.44 | $1,380.38 |
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 $275.42 Median $912.01 Typical High $1,698.24 | Professional | None | $275.42 | $912.01 | $1,698.24 |
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 $218.78 Median $537.03 Typical High $1,445.44 | Professional | None | $218.78 | $537.03 | $1,445.44 |
Martin's Point Setting Professional Modifier None Typical Low $234.42 Median $794.33 Typical High $1,230.27 | Professional | None | $234.42 | $794.33 | $1,230.27 |
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 $269.15 Median $537.03 Typical High $1,318.26 | Professional | None | $269.15 | $537.03 | $1,318.26 |
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 $131.83 Median $131.83 Typical High $489.78 | Professional | 52 · Reduced service | $131.83 | $131.83 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $194.98 | Professional | 53 · Discontinued | $52.48 | $52.48 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $741.31 | Professional | 54 · Surgery only | $194.98 | $194.98 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $147.91 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $97.72 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $489.78 | Professional | 52 · Reduced service | $131.83 | $131.83 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $194.98 | Professional | 53 · Discontinued | $52.48 | $52.48 | $194.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $741.31 | Professional | 54 · Surgery only | $194.98 | $194.98 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $147.91 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $97.72 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $97.72 |
Where Maine sits
The same service costs 3.8 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 $5,124MT $1,344
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.