How much rates vary
Facilitymedian $2,754 · 10th to 90th $537 to $19,498Professionalmedian $562 · 10th to 90th $269 to $5,012
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 $416.87 Median $416.87 Typical High $2,398.83 | Professional | None | $416.87 | $416.87 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $933.25 | Professional | None | $426.58 | $562.34 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $11,748.98 Typical High $19,498.45 | Facility | None | $537.03 | $11,748.98 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $977.24 Typical High $5,623.41 | Professional | None | $467.74 | $977.24 | $5,623.41 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $218.78 Median $645.65 Typical High $7,413.10 | Professional | None | $218.78 | $645.65 | $7,413.10 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $2,398.83 | Professional | None | $416.87 | $416.87 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $2,454.71 | Professional | None | $199.53 | $346.74 | $2,454.71 |
12 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 $208.93 Median $208.93 Typical High $1,202.26 | Professional | 52 · Reduced service | $208.93 | $208.93 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $478.63 | Professional | 53 · Discontinued | $83.18 | $83.18 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,819.70 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $363.08 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $239.88 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $1,698.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $1,202.26 | Professional | 52 · Reduced service | $208.93 | $208.93 | $1,202.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $478.63 | Professional | 53 · Discontinued | $83.18 | $83.18 | $478.63 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,819.70 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,819.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $363.08 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $363.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $239.88 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $239.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $1,698.24 |
Where Maine sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.