How much rates vary
Facilitymedian $339 · 10th to 90th $145 to $617Professionalmedian $263 · 10th to 90th $162 to $407
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 $144.54 Median $144.54 Typical High $165.96 | Facility | None | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $363.08 | Professional | None | $144.54 | $165.96 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $407.38 | Professional | None | $165.96 | $245.47 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $338.84 Typical High $1,412.54 | Facility | None | $147.91 | $338.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $467.74 | Professional | None | $245.47 | $316.23 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $426.58 | Professional | None | $204.17 | $281.84 | $426.58 |
Martin's Point Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $363.08 | Professional | None | $144.54 | $165.96 | $363.08 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
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 $72.44 Median $77.62 Typical High $83.18 | Professional | 52 · Reduced service | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | 54 · Surgery only | $109.65 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $107.15 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $102.33 | $107.15 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $72.44 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $33.11 | $33.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $109.65 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $16.60 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $117.49 |
Where Maine sits
The same service costs 4.4 times more in Alaska than in Florida. 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.
Maine· 17th of 51
$263
AK $759FL $174
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.