How much rates vary
Facilitymedian $1,905 · 10th to 90th $813 to $3,090Professionalmedian $398 · 10th to 90th $224 to $741
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 $223.87 Median $223.87 Typical High $398.11 | Facility | None | $223.87 | $223.87 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $645.65 | Professional | None | $223.87 | $389.05 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $776.25 | Professional | None | $213.80 | $407.38 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $263.03 Typical High $524.81 | Professional | 62 · Two surgeons | $147.91 | $263.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $812.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $776.25 | Professional | None | $302.00 | $489.78 | $776.25 |
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 $281.84 Median $489.78 Typical High $758.58 | Professional | None | $281.84 | $489.78 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $645.65 | Professional | None | $223.87 | $389.05 | $645.65 |
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 $354.81 Median $489.78 Typical High $724.44 | Professional | None | $354.81 | $489.78 | $724.44 |
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 $112.20 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $33.88 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $158.49 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $63.10 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $234.42 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $33.88 | $46.77 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $39.81 |
Where Maine sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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 $4,893WV $835
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.