How much rates vary
Facilitymedian $933 · 10th to 90th $129 to $1,413Professionalmedian $240 · 10th to 90th $145 to $427
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 $128.82 Median $128.82 Typical High $177.83 | Facility | None | $128.82 | $128.82 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $371.54 | Professional | None | $128.82 | $177.83 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $426.58 | Professional | None | $169.82 | $239.88 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,412.54 | Facility | None | $537.03 | $1,000.00 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $467.74 | Professional | None | $181.97 | $257.04 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $446.68 | Professional | None | $186.21 | $288.40 | $446.68 |
Martin's Point Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $371.54 | Professional | None | $128.82 | $177.83 | $371.54 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $389.05 | Professional | None | $204.17 | $275.42 | $389.05 |
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 $64.57 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $112.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $91.20 | $112.20 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $85.11 | $89.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $33.88 | $35.48 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $128.82 | $131.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $19.50 | $25.70 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $16.98 | $17.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $120.23 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $91.20 | $120.23 | $123.03 |
Where Maine sits
The same service costs 4.6 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· 26th of 51
$240
AK $794KY $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.