How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $4,266Professionalmedian $550 · 10th to 90th $417 to $851
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 $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $851.14 | Professional | None | $436.52 | $575.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $3,235.94 | Facility | None | $1,148.15 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $891.25 | Professional | None | $467.74 | $616.60 | $891.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $812.83 | Professional | None | $416.87 | $524.81 | $812.83 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $724.44 | Professional | None | $371.54 | $524.81 | $724.44 |
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 $229.09 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $316.23 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $389.05 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $389.05 |
Where Maine sits
The same service costs 6.0 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 $8,653MT $1,432
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.