How much rates vary
Facilitymedian $501 · 10th to 90th $200 to $813Professionalmedian $398 · 10th to 90th $224 to $741
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 $199.53 Median $199.53 Typical High $323.59 | Facility | None | $199.53 | $199.53 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $537.03 | Professional | None | $199.53 | $323.59 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $741.31 | Professional | None | $245.47 | $398.11 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,290.87 | Facility | None | $467.74 | $724.44 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $758.58 | Professional | None | $346.74 | $537.03 | $758.58 |
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 $302.00 Median $467.74 Typical High $758.58 | Professional | None | $302.00 | $467.74 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $537.03 | Professional | None | $199.53 | $323.59 | $537.03 |
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 $323.59 Median $489.78 Typical High $707.95 | Professional | None | $323.59 | $489.78 | $707.95 |
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 $100.00 Median $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 54 · Surgery only | $151.36 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $173.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $141.25 | $173.78 | $223.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $125.89 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $50.12 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 54 · Surgery only | $151.36 | $186.21 | $239.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $47.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $32.36 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $173.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $141.25 | $173.78 | $223.87 |
Where Maine sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$398
AK $1,000UT $302
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.