How much rates vary
Facilitymedian $417 · 10th to 90th $87 to $1,413Professionalmedian $162 · 10th to 90th $100 to $288
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 $87.10 Median $128.82 Typical High $128.82 | Facility | None | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $263.03 | Professional | None | $87.10 | $128.82 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $302.00 | Professional | None | $107.15 | $169.82 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $275.42 Typical High $1,412.54 | Facility | None | $123.03 | $275.42 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $316.23 | Professional | None | $123.03 | $181.97 | $316.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $309.03 | Professional | None | $123.03 | $194.98 | $309.03 |
Martin's Point Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $22,387.21 | Facility | None | $13,803.84 | $13,803.84 | $22,387.21 |
Martin's Point Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $263.03 | Professional | None | $87.10 | $128.82 | $263.03 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $275.42 | Professional | None | $141.25 | $199.53 | $275.42 |
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 $43.65 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $66.07 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $56.23 | $64.57 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $22.39 | $25.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $66.07 | $85.11 | $95.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $12.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $89.13 |
Where Maine sits
The same service costs 3.5 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· 26th of 51
$162
AK $447FL $126
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.