How much rates vary
Facilitymedian $339 · 10th to 90th $54 to $708Professionalmedian $107 · 10th to 90th $63 to $204
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 Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $89.13 | Facility | None | $53.70 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $181.97 | Professional | None | $53.70 | $89.13 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $213.80 | Professional | None | $64.57 | $112.20 | $213.80 |
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 $74.13 Median $128.82 Typical High $218.78 | Professional | None | $74.13 | $128.82 | $218.78 |
Community Health Options Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $229.09 | Professional | None | $100.00 | $165.96 | $229.09 |
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 $77.62 Median $134.90 Typical High $213.80 | Professional | None | $77.62 | $134.90 | $213.80 |
Martin's Point Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $15,848.93 | Facility | None | $8,912.51 | $8,912.51 | $15,848.93 |
Martin's Point Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $181.97 | Professional | None | $53.70 | $89.13 | $181.97 |
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 $89.13 Median $134.90 Typical High $194.98 | Professional | None | $89.13 | $134.90 | $194.98 |
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 $26.92 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $10.72 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $53.70 Typical High $67.61 | Professional | 54 · Surgery only | $40.74 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $50.12 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $38.02 | $50.12 | $63.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $36.31 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $10.72 | $14.45 | $17.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $53.70 Typical High $67.61 | Professional | 54 · Surgery only | $40.74 | $53.70 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $10.72 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $8.91 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $50.12 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $38.02 | $50.12 | $63.10 |
Where Maine sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 27th of 51
$110
AK $309KY $79.43
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.