How much rates vary
Facilitymedian $708 · 10th to 90th $437 to $1,202Professionalmedian $324 · 10th to 90th $182 to $589
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 $169.82 Median $251.19 Typical High $436.52 | Professional | None | $169.82 | $251.19 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $588.84 | Professional | None | $213.80 | $338.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $1,862.09 | Facility | None | $446.68 | $691.83 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $602.56 | Professional | None | $234.42 | $354.81 | $602.56 |
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 $223.87 Median $389.05 Typical High $602.56 | Professional | None | $223.87 | $389.05 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $436.52 | Professional | None | $169.82 | $251.19 | $436.52 |
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 $269.15 Median $389.05 Typical High $562.34 | Professional | None | $269.15 | $389.05 | $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 $85.11 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $25.70 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $120.23 | $151.36 | $173.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $109.65 | $125.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $43.65 | $50.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $162.18 | $186.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $25.70 | $32.36 | $38.02 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $25.12 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $120.23 | $151.36 | $173.78 |
Where Maine sits
The same service costs 3.6 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
$331
AK $851KY $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.