How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $6,310Professionalmedian $813 · 10th to 90th $631 to $1,230
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 $660.69 Median $812.83 Typical High $1,174.90 | Professional | None | $660.69 | $812.83 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,230.27 | Professional | None | $630.96 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,862.09 | Professional | 50 · Both sides | $954.99 | $1,230.27 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $512.86 Typical High $776.25 | Professional | 62 · Two surgeons | $398.11 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,238.72 Typical High $2,951.21 | Facility | None | $707.95 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,318.26 | Professional | None | $724.44 | $891.25 | $1,318.26 |
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 $645.65 Median $831.76 Typical High $1,174.90 | Professional | None | $645.65 | $831.76 | $1,174.90 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,174.90 | Professional | None | $676.08 | $812.83 | $1,174.90 |
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 $630.96 Median $831.76 Typical High $1,122.02 | Professional | None | $630.96 | $831.76 | $1,122.02 |
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 $338.84 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $575.44 |
Where Maine sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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 $11,248TX $1,472
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.