How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $2,818Professionalmedian $204 · 10th to 90th $135 to $257
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 $190.55 Median $208.93 Typical High $223.87 | Professional | None | $190.55 | $208.93 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $257.04 | Professional | None | $125.89 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | 50 · Both sides | $190.55 | $275.42 | $380.19 |
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 $186.21 Median $204.17 Typical High $288.40 | Professional | None | $186.21 | $204.17 | $288.40 |
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 $134.90 Median $199.53 Typical High $269.15 | Professional | None | $134.90 | $199.53 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $234.42 | Professional | None | $169.82 | $208.93 | $234.42 |
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 $134.90 Median $213.80 Typical High $275.42 | Professional | None | $134.90 | $213.80 | $275.42 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $144.54 |
Where Maine sits
The same service costs 11.0 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 $4,556MT $413
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.