How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $9,333Professionalmedian $891 · 10th to 90th $562 to $10,000
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 $645.65 Median $891.25 Typical High $8,511.38 | Professional | None | $645.65 | $891.25 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,380.38 | Professional | None | $489.78 | $724.44 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $9,332.54 | Facility | None | $707.95 | $5,011.87 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $10,471.29 | Professional | None | $691.83 | $1,174.90 | $10,471.29 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $562.34 Median $5,248.07 Typical High $11,220.18 | Professional | None | $562.34 | $5,248.07 | $11,220.18 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $8,511.38 | Professional | None | $645.65 | $891.25 | $8,511.38 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $512.86 Median $5,248.07 Typical High $11,481.54 | Professional | None | $512.86 | $5,248.07 | $11,481.54 |
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 $323.59 Median $323.59 Typical High $4,265.80 | Professional | 52 · Reduced service | $323.59 | $323.59 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $1,698.24 | Professional | 53 · Discontinued | $128.82 | $128.82 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $6,456.54 | Professional | 54 · Surgery only | $489.78 | $489.78 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $1,288.25 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $851.14 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $6,025.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $4,265.80 | Professional | 52 · Reduced service | $323.59 | $323.59 | $4,265.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $1,698.24 | Professional | 53 · Discontinued | $128.82 | $128.82 | $1,698.24 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $6,456.54 | Professional | 54 · Surgery only | $489.78 | $489.78 | $6,456.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $1,288.25 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $1,288.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $851.14 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $851.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $6,025.60 |
Where Maine sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.