How much rates vary
Facilitymedian $525 · 10th to 90th $339 to $708Professionalmedian $537 · 10th to 90th $331 to $891
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 $281.84 Median $371.54 Typical High $426.58 | Professional | None | $281.84 | $371.54 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $891.25 | Professional | None | $331.13 | $537.03 | $891.25 |
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 $398.11 Median $537.03 Typical High $1,023.29 | Professional | None | $398.11 | $537.03 | $1,023.29 |
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 $398.11 Median $616.60 Typical High $912.01 | Professional | None | $398.11 | $616.60 | $912.01 |
Martin's Point Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $436.52 | Professional | None | $281.84 | $380.19 | $436.52 |
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 $457.09 Median $616.60 Typical High $870.96 | Professional | None | $457.09 | $616.60 | $870.96 |
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 $141.25 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $141.25 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $42.66 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $257.04 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $257.04 | $269.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $141.25 | $186.21 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $74.13 | $75.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $281.84 | $288.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $38.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $269.15 |
Where Maine sits
The same service costs 4.7 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· 15th of 51
$537
AK $1,445TX $309
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.