How much rates vary
Facilitymedian $501 · 10th to 90th $195 to $708Professionalmedian $490 · 10th to 90th $324 to $603
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 $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $602.56 | Professional | None | $295.12 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $676.08 Typical High $912.01 | Professional | 50 · Both sides | $457.09 | $676.08 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $281.84 Typical High $707.95 | Facility | None | $56.23 | $281.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $645.65 | Professional | None | $416.87 | $501.19 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $588.84 | Professional | None | $323.59 | $436.52 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $575.44 | Professional | None | $309.03 | $446.68 | $575.44 |
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 $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 54 · Surgery only | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $354.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 54 · Surgery only | $371.54 | $371.54 | $380.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $354.81 |
Where Maine sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.