How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $912 · 10th to 90th $603 to $1,479
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 $524.81 Median $630.96 Typical High $1,122.02 | Professional | None | $524.81 | $630.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,479.11 | Professional | None | $616.60 | $912.01 | $1,479.11 |
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 $724.44 Median $891.25 Typical High $1,778.28 | Professional | None | $724.44 | $891.25 | $1,778.28 |
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 $707.95 Median $1,071.52 Typical High $1,548.82 | Professional | None | $707.95 | $1,071.52 | $1,548.82 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,122.02 | Professional | None | $524.81 | $630.96 | $1,122.02 |
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 $776.25 Median $1,096.48 Typical High $1,479.11 | Professional | None | $776.25 | $1,096.48 | $1,479.11 |
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 $263.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $446.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $446.68 |
Where Maine sits
The same service costs 4.5 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· 24th of 51
$912
AK $2,630TX $589
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.