How much rates vary
Facilitymedian $339 · 10th to 90th $162 to $692Professionalmedian $309 · 10th to 90th $191 to $550
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 $162.18 Median $162.18 Typical High $245.47 | Facility | None | $162.18 | $162.18 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $512.86 | Professional | None | $162.18 | $245.47 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $588.84 | Professional | None | $190.55 | $323.59 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $338.84 Typical High $707.95 | Facility | None | $56.23 | $338.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $602.56 | Professional | None | $275.42 | $426.58 | $602.56 |
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 $218.78 Median $371.54 Typical High $602.56 | Professional | None | $218.78 | $371.54 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $512.86 | Professional | None | $162.18 | $245.47 | $512.86 |
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 $251.19 Median $371.54 Typical High $524.81 | Professional | None | $251.19 | $371.54 | $524.81 |
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 $79.43 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $144.54 | $169.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $102.33 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $40.74 | $48.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $154.88 | $181.97 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $36.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $24.55 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $144.54 | $169.82 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$309
AK $813MD $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.