How much rates vary
Facilitymedian $2,188 · 10th to 90th $708 to $3,162Professionalmedian $776 · 10th to 90th $589 to $1,148
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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,096.48 | Professional | None | $660.69 | $707.95 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,230.27 | Professional | None | $588.84 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $478.63 Typical High $724.44 | Professional | 62 · Two surgeons | $371.54 | $478.63 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $3,162.28 | Facility | None | $1,000.00 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,318.26 | Professional | None | $660.69 | $851.14 | $1,318.26 |
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 $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $912.01 | Professional | None | $691.83 | $707.95 | $912.01 |
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 $575.44 Median $812.83 Typical High $1,174.90 | Professional | None | $575.44 | $812.83 | $1,174.90 |
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 $302.00 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Maine sits
The same service costs 4.0 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 $7,771MT $1,932
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.