How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,042Professionalmedian $479 · 10th to 90th $316 to $776
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 $316.23 Median $446.68 Typical High $602.56 | Professional | None | $316.23 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $630.96 | Professional | None | $302.00 | $457.09 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $691.83 Typical High $954.99 | Professional | 50 · Both sides | $446.68 | $691.83 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $2,238.72 | Facility | None | $537.03 | $1,412.54 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $912.01 | Professional | None | $436.52 | $630.96 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $891.25 | Professional | None | $371.54 | $575.44 | $891.25 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $602.56 | Professional | None | $316.23 | $446.68 | $602.56 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $812.83 | Professional | None | $416.87 | $588.84 | $812.83 |
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 $158.49 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $158.49 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $234.42 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $218.78 | $263.03 | $316.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $158.49 | $186.21 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $75.86 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $234.42 | $281.84 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $44.67 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $218.78 | $263.03 | $316.23 |
Where Maine sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.