How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $2,818Professionalmedian $537 · 10th to 90th $355 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 Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $645.65 | Professional | None | $380.19 | $562.34 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $691.83 | Professional | None | $338.84 | $501.19 | $691.83 |
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 $446.68 Median $562.34 Typical High $724.44 | Professional | None | $446.68 | $562.34 | $724.44 |
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 $371.54 Median $489.78 Typical High $616.60 | Professional | None | $371.54 | $489.78 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $645.65 | Professional | None | $380.19 | $562.34 | $645.65 |
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 $354.81 Median $512.86 Typical High $660.69 | Professional | None | $354.81 | $512.86 | $660.69 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Where Maine sits
The same service costs 4.5 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 $4,914MT $1,099
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.