How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $2,291Professionalmedian $977 · 10th to 90th $661 to $1,660
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 $575.44 Median $588.84 Typical High $691.83 | Professional | None | $575.44 | $588.84 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,659.59 | Professional | None | $691.83 | $977.24 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $2,290.87 | Facility | None | $707.95 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,949.84 | Professional | None | $794.33 | $977.24 | $1,949.84 |
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 $812.83 Median $1,122.02 Typical High $1,737.80 | Professional | None | $812.83 | $1,122.02 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | None | $575.44 | $691.83 | $691.83 |
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 $831.76 Median $1,122.02 Typical High $1,621.81 | Professional | None | $831.76 | $1,122.02 | $1,621.81 |
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 $288.40 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $489.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $489.78 |
Where Maine sits
The same service costs 4.9 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· 21st of 51
$977
AK $2,884TX $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.