How much rates vary
Facilitymedian $339 · 10th to 90th $83 to $708Professionalmedian $162 · 10th to 90th $89 to $282
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 $83.18 Median $123.03 Typical High $14,454.40 | Facility | None | $83.18 | $123.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $257.04 | Professional | None | $83.18 | $123.03 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $288.40 | Professional | None | $102.33 | $162.18 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $186.21 Typical High $707.95 | Facility | None | $56.23 | $186.21 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $302.00 | Professional | None | $138.04 | $204.17 | $302.00 |
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 $125.89 Median $194.98 Typical High $302.00 | Professional | None | $125.89 | $194.98 | $302.00 |
Martin's Point Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $22,387.21 | Facility | None | $14,454.40 | $14,454.40 | $22,387.21 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $257.04 | Professional | None | $83.18 | $123.03 | $257.04 |
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 $128.82 Median $186.21 Typical High $269.15 | Professional | None | $128.82 | $186.21 | $269.15 |
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 $41.69 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $16.60 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $91.20 | Professional | 54 · Surgery only | $61.66 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $72.44 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $57.54 | $72.44 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $54.95 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $16.60 | $21.88 | $24.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $61.66 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $12.30 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $57.54 | $75.86 | $85.11 |
Where Maine sits
The same service costs 4.1 times more in Alaska 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.
Maine· 24th of 51
$162
AK $447KY $110
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.