How much rates vary
Facilitymedian $1,413 · 10th to 90th $447 to $2,818Professionalmedian $759 · 10th to 90th $389 to $1,479
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 $446.68 Median $446.68 Typical High $1,122.02 | Facility | None | $446.68 | $446.68 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,412.54 | Professional | None | $446.68 | $602.56 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $1,584.89 | Professional | None | $331.13 | $660.69 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $3,090.30 | Facility | None | $537.03 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,621.81 | Professional | None | $467.74 | $794.33 | $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 $380.19 Median $812.83 Typical High $1,659.59 | Professional | None | $380.19 | $812.83 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,412.54 | Professional | None | $426.58 | $602.56 | $1,412.54 |
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 $457.09 Median $812.83 Typical High $1,479.11 | Professional | None | $457.09 | $812.83 | $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 $223.87 Median $251.19 Typical High $562.34 | Professional | 52 · Reduced service | $223.87 | $251.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $223.87 | Professional | 53 · Discontinued | $89.13 | $100.00 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $851.14 | Professional | 54 · Surgery only | $331.13 | $380.19 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $169.82 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $112.20 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $251.19 Typical High $562.34 | Professional | 52 · Reduced service | $223.87 | $251.19 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $223.87 | Professional | 53 · Discontinued | $89.13 | $100.00 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $851.14 | Professional | 54 · Surgery only | $331.13 | $380.19 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $169.82 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $112.20 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $112.20 |
Where Maine sits
The same service costs 3.7 times more in Wisconsin than in North Dakota. 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
WI $6,561ND $1,783
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.