How much rates vary
Facilitymedian $1,905 · 10th to 90th $708 to $3,311Professionalmedian $813 · 10th to 90th $282 to $2,042
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 $331.13 Median $331.13 Typical High $1,479.11 | Facility | None | $331.13 | $331.13 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $660.69 Typical High $1,479.11 | Professional | None | $323.59 | $660.69 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $812.83 Typical High $2,041.74 | Professional | None | $239.88 | $812.83 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $1,202.26 Typical High $3,090.30 | Professional | 50 · Both sides | $398.11 | $1,202.26 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $4,466.84 | Facility | None | $707.95 | $2,344.23 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $2,089.30 | Professional | None | $338.84 | $588.84 | $2,089.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $1,096.48 Typical High $2,041.74 | Professional | None | $275.42 | $1,096.48 | $2,041.74 |
Martin's Point Setting Professional Modifier None Typical Low $323.59 Median $660.69 Typical High $1,479.11 | Professional | None | $323.59 | $660.69 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $1,949.84 | Professional | None | $363.08 | $676.08 | $1,949.84 |
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 $165.96 Median $199.53 Typical High $741.31 | Professional | 52 · Reduced service | $165.96 | $199.53 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $79.43 Typical High $295.12 | Professional | 53 · Discontinued | $66.07 | $79.43 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $245.47 | $302.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $223.87 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $39.81 Typical High $147.91 | Professional | 56 · Pre-op care only | $33.11 | $39.81 | $147.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $199.53 Typical High $741.31 | Professional | 52 · Reduced service | $165.96 | $199.53 | $741.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $79.43 Typical High $295.12 | Professional | 53 · Discontinued | $66.07 | $79.43 | $295.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $245.47 | $302.00 | $1,122.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $223.87 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $223.87 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $39.81 Typical High $147.91 | Professional | 56 · Pre-op care only | $33.11 | $39.81 | $147.91 |
Where Maine sits
The same service costs 3.2 times more in Oklahoma than in Kentucky. 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 $6,075KY $1,891
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.