How much rates vary
Facilitymedian $851 · 10th to 90th $195 to $1,585Professionalmedian $339 · 10th to 90th $229 to $603
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 $194.98 Median $194.98 Typical High $251.19 | Facility | None | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $537.03 | Professional | None | $194.98 | $251.19 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $602.56 | Professional | None | $251.19 | $338.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,862.09 | Facility | None | $707.95 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $707.95 | Professional | None | $275.42 | $363.08 | $707.95 |
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 $281.84 Median $416.87 Typical High $645.65 | Professional | None | $281.84 | $416.87 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $537.03 | Professional | None | $194.98 | $251.19 | $537.03 |
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 $302.00 Median $416.87 Typical High $562.34 | Professional | None | $302.00 | $416.87 | $562.34 |
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 $97.72 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $147.91 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $177.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $50.12 | $50.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $147.91 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $138.04 | $177.83 | $177.83 |
Where Maine sits
The same service costs 4.8 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· 28th of 51
$347
AK $1,202KY $251
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.