How much rates vary
Facilitymedian $1,072 · 10th to 90th $263 to $2,455Professionalmedian $347 · 10th to 90th $219 to $692
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 $489.78 | Facility | None | $263.03 | $263.03 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $741.31 | Professional | None | $245.47 | $346.74 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $446.68 | Professional | None | $186.21 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,698.24 | Facility | None | $707.95 | $1,288.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $691.83 | Professional | None | $239.88 | $446.68 | $691.83 |
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 $213.80 Median $389.05 Typical High $870.96 | Professional | None | $213.80 | $389.05 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $741.31 | Professional | None | $245.47 | $346.74 | $741.31 |
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 $229.09 Median $389.05 Typical High $691.83 | Professional | None | $229.09 | $389.05 | $691.83 |
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 $131.83 Median $131.83 Typical High $245.47 | Professional | 52 · Reduced service | $131.83 | $131.83 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $52.48 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $371.54 | Professional | 54 · Surgery only | $199.53 | $199.53 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $74.13 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $48.98 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $407.38 Typical High $549.54 | Professional | 50 · Both sides | $281.84 | $407.38 | $549.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $245.47 | Professional | 52 · Reduced service | $131.83 | $131.83 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $52.48 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $371.54 | Professional | 54 · Surgery only | $199.53 | $199.53 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $74.13 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $48.98 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $48.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $346.74 |
Where Maine sits
The same service costs 4.6 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 $4,728MT $1,029
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.