How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $2,951Professionalmedian $933 · 10th to 90th $617 to $1,585
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 $537.03 Median $676.08 Typical High $724.44 | Professional | None | $537.03 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,584.89 | Professional | None | $645.65 | $912.01 | $1,584.89 |
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 $741.31 Median $933.25 Typical High $1,862.09 | Professional | None | $741.31 | $933.25 | $1,862.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,698.24 | Professional | None | $741.31 | $1,096.48 | $1,698.24 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $724.44 | Professional | None | $537.03 | $676.08 | $724.44 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,548.82 | Professional | None | $794.33 | $1,122.02 | $1,548.82 |
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 $269.15 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $467.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $467.74 |
Where Maine sits
The same service costs 3.1 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.
Physician feeFacility fee
AK $5,990MD $1,938
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.