How much rates vary
Facilitymedian $741 · 10th to 90th $417 to $1,349Professionalmedian $316 · 10th to 90th $209 to $537
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 $181.97 Median $181.97 Typical High $223.87 | Facility | None | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $398.11 | Professional | None | $181.97 | $223.87 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $537.03 | Professional | None | $213.80 | $309.03 | $537.03 |
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 $251.19 Median $323.59 Typical High $630.96 | Professional | None | $251.19 | $323.59 | $630.96 |
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 $245.47 Median $371.54 Typical High $562.34 | Professional | None | $245.47 | $371.54 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $398.11 | Professional | None | $181.97 | $223.87 | $398.11 |
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 $275.42 Median $380.19 Typical High $512.86 | Professional | None | $275.42 | $380.19 | $512.86 |
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 $91.20 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $169.82 | Professional | 54 · Surgery only | $134.90 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $134.90 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $125.89 | $158.49 | $158.49 |
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· 25th of 51
$324
AK $912KY $234
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.