How much rates vary
Facilitymedian $741 · 10th to 90th $617 to $1,862Professionalmedian $158 · 10th to 90th $107 to $224
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 $158.49 Median $158.49 Typical High $223.87 | Professional | None | $158.49 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $194.98 | Professional | None | $87.10 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | 50 · Both sides | $144.54 | $204.17 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $1,949.84 | Facility | None | $707.95 | $1,479.11 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $275.42 | Professional | None | $154.88 | $194.98 | $275.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $239.88 | Professional | None | $107.15 | $165.96 | $239.88 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $223.87 | Professional | None | $158.49 | $158.49 | $223.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $239.88 | Professional | None | $107.15 | $162.18 | $239.88 |
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 $79.43 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $79.43 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $31.62 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $117.49 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $22.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $79.43 | $79.43 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $31.62 | $31.62 | $44.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $117.49 | $117.49 | $165.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $33.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $22.39 |
Where Maine sits
The same service costs 10.9 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 $3,950MT $363
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.