How much rates vary
Facilitymedian $708 · 10th to 90th $204 to $1,047Professionalmedian $316 · 10th to 90th $186 to $562
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 $239.88 Typical High $407.38 | Professional | None | $169.82 | $239.88 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $562.34 | Professional | None | $213.80 | $323.59 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $295.12 Typical High $707.95 | Facility | None | $56.23 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | None | $234.42 | $338.84 | $588.84 |
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 $363.08 Typical High $575.44 | Professional | None | $223.87 | $363.08 | $575.44 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $407.38 | Professional | None | $169.82 | $239.88 | $407.38 |
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 $263.03 Median $371.54 Typical High $537.03 | Professional | None | $263.03 | $371.54 | $537.03 |
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 $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $147.91 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $107.15 | $120.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $33.88 | $42.66 | $47.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $158.49 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $36.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $23.99 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $147.91 | $165.96 |
Where Maine sits
The same service costs 3.9 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· 21st of 51
$324
AK $851TX $219
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.