How much rates vary
Facilitymedian $525 · 10th to 90th $339 to $708Professionalmedian $219 · 10th to 90th $126 to $427
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 $107.15 Median $138.04 Typical High $194.98 | Professional | None | $107.15 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $426.58 | Professional | None | $138.04 | $229.09 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $436.52 | Professional | None | $147.91 | $263.03 | $436.52 |
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 $151.36 Median $263.03 Typical High $446.68 | Professional | None | $151.36 | $263.03 | $446.68 |
Martin's Point Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $194.98 | Professional | None | $107.15 | $138.04 | $194.98 |
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 $177.83 Median $269.15 Typical High $436.52 | Professional | None | $177.83 | $269.15 | $436.52 |
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 $53.70 Median $69.18 Typical High $97.72 | Professional | 52 · Reduced service | $53.70 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $21.38 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $81.28 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $97.72 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $75.86 | $97.72 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $97.72 | Professional | 52 · Reduced service | $53.70 | $69.18 | $97.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $21.38 | $27.54 | $38.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $81.28 | $104.71 | $144.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $28.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $19.50 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $97.72 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $75.86 | $97.72 | $134.90 |
Where Maine sits
The same service costs 3.8 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
$229
AK $603MD $158
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.