How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $10,471Professionalmedian $417 · 10th to 90th $229 to $2,884
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 $208.93 Median $398.11 Typical High $2,238.72 | Professional | None | $208.93 | $398.11 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $660.69 | Professional | None | $316.23 | $426.58 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $7,762.47 Typical High $10,471.29 | Facility | None | $707.95 | $7,762.47 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $724.44 Typical High $3,235.94 | Professional | None | $398.11 | $724.44 | $3,235.94 |
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 $213.80 Median $446.68 Typical High $4,168.69 | Professional | None | $213.80 | $446.68 | $4,168.69 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $2,238.72 | Professional | None | $208.93 | $398.11 | $2,238.72 |
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 $194.98 Median $338.84 Typical High $2,290.87 | Professional | None | $194.98 | $338.84 | $2,290.87 |
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 $199.53 Median $199.53 Typical High $1,122.02 | Professional | 52 · Reduced service | $199.53 | $199.53 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $446.68 | Professional | 53 · Discontinued | $81.28 | $81.28 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,659.59 | Professional | 54 · Surgery only | $302.00 | $302.00 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $331.13 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $223.87 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $1,548.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $1,122.02 | Professional | 52 · Reduced service | $199.53 | $199.53 | $1,122.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $446.68 | Professional | 53 · Discontinued | $81.28 | $81.28 | $446.68 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,659.59 | Professional | 54 · Surgery only | $302.00 | $302.00 | $1,659.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $331.13 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $331.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $223.87 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $223.87 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $1,548.82 |
Where Maine sits
The same service costs 13.1 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 $15,603MT $1,192
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.