How much rates vary
Facilitymedian $1,202 · 10th to 90th $347 to $1,622Professionalmedian $372 · 10th to 90th $282 to $550
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 Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $562.34 | Professional | None | $269.15 | $398.11 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,862.09 | Facility | None | $707.95 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $616.60 | Professional | None | $354.81 | $407.38 | $616.60 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $549.54 | Professional | None | $288.40 | $371.54 | $549.54 |
Martin's Point Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $549.54 | Professional | None | $281.84 | $398.11 | $549.54 |
10 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 $162.18 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $239.88 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Where Maine sits
The same service costs 5.2 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 $4,508MT $873
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.