How much rates vary
Facilitymedian $2,239 · 10th to 90th $708 to $4,266Professionalmedian $692 · 10th to 90th $427 to $2,692
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 $512.86 Median $562.34 Typical High $2,290.87 | Professional | None | $512.86 | $562.34 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $1,096.48 | Professional | None | $389.05 | $575.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,238.72 Typical High $8,511.38 | Facility | None | $707.95 | $2,238.72 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $2,691.53 | Professional | None | $562.34 | $954.99 | $2,691.53 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $1,412.54 Typical High $3,388.44 | Professional | None | $446.68 | $1,412.54 | $3,388.44 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $2,290.87 | Professional | None | $512.86 | $562.34 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $416.87 Median $1,412.54 Typical High $2,754.23 | Professional | None | $416.87 | $1,412.54 | $2,754.23 |
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 $257.04 Median $257.04 Typical High $1,148.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $457.09 | Professional | 53 · Discontinued | $102.33 | $102.33 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,737.80 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $346.74 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $229.09 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,621.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $1,148.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $1,148.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $457.09 | Professional | 53 · Discontinued | $102.33 | $102.33 | $457.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,737.80 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,737.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $346.74 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $346.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $229.09 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $229.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,621.81 |
Where Maine sits
The same service costs 4.4 times more in Oklahoma than in Maryland. 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
OK $10,373MD $2,367
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.