How much rates vary
Facilitymedian $417 · 10th to 90th $115 to $1,047Professionalmedian $204 · 10th to 90th $135 to $363
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 $114.82 Median $114.82 Typical High $151.36 | Facility | None | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $316.23 | Professional | None | $114.82 | $151.36 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $363.08 | Professional | None | $144.54 | $204.17 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $338.84 Typical High $1,412.54 | Facility | None | $147.91 | $338.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $426.58 | Professional | None | $162.18 | $218.78 | $426.58 |
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 $162.18 Median $245.47 Typical High $371.54 | Professional | None | $162.18 | $245.47 | $371.54 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $316.23 | Professional | None | $114.82 | $151.36 | $316.23 |
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 $181.97 Median $245.47 Typical High $338.84 | Professional | None | $181.97 | $245.47 | $338.84 |
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 $57.54 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $107.15 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $100.00 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $81.28 | $100.00 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $107.15 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $81.28 | $107.15 | $107.15 |
Where Maine sits
The same service costs 3.9 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
$204
AK $603KY $155
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.