How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $708 · 10th to 90th $550 to $1,096
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 $588.84 Median $707.95 Typical High $707.95 | Professional | None | $588.84 | $707.95 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,096.48 | Professional | None | $562.34 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $2,951.21 | Facility | None | $812.83 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,202.26 | Professional | None | $645.65 | $794.33 | $1,202.26 |
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 $549.54 Median $691.83 Typical High $1,047.13 | Professional | None | $549.54 | $691.83 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | None | $660.69 | $707.95 | $707.95 |
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 $537.03 Median $707.95 Typical High $933.25 | Professional | None | $537.03 | $707.95 | $933.25 |
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 $295.12 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $489.78 |
Where Maine sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.