How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $2,818Professionalmedian $692 · 10th to 90th $468 to $912
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 $489.78 Median $691.83 Typical High $891.25 | Professional | None | $489.78 | $691.83 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $851.14 | Professional | None | $398.11 | $602.56 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $933.25 Typical High $1,288.25 | Professional | 50 · Both sides | $630.96 | $933.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,290.87 | Facility | None | $812.83 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,122.02 | Professional | None | $691.83 | $870.96 | $1,122.02 |
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 $478.63 Median $741.31 Typical High $954.99 | Professional | None | $478.63 | $741.31 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $891.25 | Professional | None | $489.78 | $691.83 | $891.25 |
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 $467.74 Median $691.83 Typical High $954.99 | Professional | None | $467.74 | $691.83 | $954.99 |
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 $346.74 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $630.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $346.74 | $446.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $138.04 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $524.81 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $89.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $630.96 |
Where Maine sits
The same service costs 4.0 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 $5,056WV $1,262
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.