How much rates vary
Facilitymedian $269 · 10th to 90th $135 to $617Professionalmedian $275 · 10th to 90th $158 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 Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $218.78 | Facility | None | $134.90 | $186.21 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $407.38 | Professional | None | $134.90 | $218.78 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $524.81 | Professional | None | $169.82 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $323.59 Typical High $707.95 | Facility | None | $56.23 | $323.59 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $549.54 | Professional | None | $234.42 | $380.19 | $549.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $549.54 | Professional | None | $194.98 | $331.13 | $549.54 |
Martin's Point Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $346.74 | Facility | None | $134.90 | $186.21 | $346.74 |
Martin's Point Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $478.63 | Professional | None | $134.90 | $218.78 | $478.63 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $467.74 | Professional | None | $223.87 | $331.13 | $467.74 |
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 $67.61 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $95.50 | $120.23 | $151.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $87.10 | $109.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $34.67 | $43.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $128.82 | $162.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $32.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $17.38 | $21.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $95.50 | $120.23 | $151.36 |
Where Maine sits
The same service costs 3.4 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· 21st of 51
$275
AK $692KY $204
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.