How much rates vary
Facilitymedian $178 · 10th to 90th $83 to $617Professionalmedian $158 · 10th to 90th $95 to $295
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 $117.49 Typical High $123.03 | Facility | None | $83.18 | $117.49 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $251.19 | Professional | None | $83.18 | $123.03 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $295.12 | Professional | None | $104.71 | $165.96 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $281.84 Typical High $1,412.54 | Facility | None | $123.03 | $281.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $302.00 | Professional | None | $117.49 | $177.83 | $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 $117.49 Median $186.21 Typical High $302.00 | Professional | None | $117.49 | $186.21 | $302.00 |
Martin's Point Setting Facility Modifier None Typical Low $83.18 Median $117.49 Typical High $190.55 | Facility | None | $83.18 | $117.49 | $190.55 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $251.19 | Professional | None | $83.18 | $123.03 | $251.19 |
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 $134.90 Median $186.21 Typical High $263.03 | Professional | None | $134.90 | $186.21 | $263.03 |
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 $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $54.95 | $61.66 |
Aetna 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 |
Aetna 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 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $16.60 | $18.62 |
Aetna 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 |
Aetna 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 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $54.95 | $61.66 |
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 $12.59 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $16.60 | $18.62 |
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 3.7 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
$158
AK $427KY $115
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.