How much rates vary
Facilitymedian $1,698 · 10th to 90th $537 to $2,570Professionalmedian $759 · 10th to 90th $525 to $1,202
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 $549.54 Median $851.14 Typical High $912.01 | Professional | None | $549.54 | $851.14 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $933.25 | Professional | None | $467.74 | $645.65 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,288.25 Typical High $1,698.24 | Facility | None | $537.03 | $1,288.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,202.26 | Professional | None | $588.84 | $891.25 | $1,202.26 |
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 $549.54 Median $851.14 Typical High $1,548.82 | Professional | None | $549.54 | $851.14 | $1,548.82 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $912.01 | Professional | None | $549.54 | $851.14 | $912.01 |
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 $478.63 Median $741.31 Typical High $1,230.27 | Professional | None | $478.63 | $741.31 | $1,230.27 |
13 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 $275.42 Median $302.00 Typical High $457.09 | Professional | 52 · Reduced service | $275.42 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $112.20 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $416.87 | $457.09 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $91.20 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $977.24 Typical High $1,380.38 | Professional | 50 · Both sides | $707.95 | $977.24 | $1,380.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | 52 · Reduced service | $275.42 | $275.42 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $181.97 | Professional | 53 · Discontinued | $112.20 | $112.20 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $676.08 | Professional | 54 · Surgery only | $416.87 | $416.87 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $91.20 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $630.96 |
Where Maine sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.