How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $1,072 · 10th to 90th $676 to $1,778
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 $616.60 Median $741.31 Typical High $1,548.82 | Professional | None | $616.60 | $741.31 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,737.80 | Professional | None | $724.44 | $1,071.52 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,290.87 | Facility | None | $812.83 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,089.30 | Professional | None | $851.14 | $1,071.52 | $2,089.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,778.28 | Professional | None | $870.96 | $1,230.27 | $1,778.28 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,548.82 | Professional | None | $616.60 | $741.31 | $1,548.82 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $933.25 | $1,288.25 | $1,737.80 |
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 $309.03 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $512.86 |
Where Maine sits
The same service costs 4.4 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· 22nd of 51
$1,072
AK $3,090TX $708
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.