How much rates vary
Facilitymedian $708 · 10th to 90th $234 to $1,202Professionalmedian $295 · 10th to 90th $174 to $525
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 Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $446.68 | Professional | None | $154.88 | $223.87 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $524.81 | Professional | None | $186.21 | $309.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $457.09 Typical High $1,412.54 | Facility | None | $199.53 | $457.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $549.54 | Professional | None | $213.80 | $316.23 | $549.54 |
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 $204.17 Median $338.84 Typical High $537.03 | Professional | None | $204.17 | $338.84 | $537.03 |
Martin's Point Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $446.68 | Professional | None | $154.88 | $223.87 | $446.68 |
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 $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
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 $77.62 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $97.72 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $39.81 | $44.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $147.91 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $19.95 | $22.39 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $158.49 |
Where Maine sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 23rd of 51
$302
AK $776TX $214
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.