How much rates vary
Facilitymedian $525 · 10th to 90th $339 to $708Professionalmedian $174 · 10th to 90th $93 to $316
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 $89.13 Median $141.25 Typical High $281.84 | Professional | None | $89.13 | $141.25 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $338.84 | Professional | None | $112.20 | $177.83 | $338.84 |
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 $123.03 Median $204.17 Typical High $346.74 | Professional | None | $123.03 | $204.17 | $346.74 |
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 $123.03 Median $208.93 Typical High $338.84 | Professional | None | $123.03 | $208.93 | $338.84 |
Martin's Point Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $281.84 | Professional | None | $89.13 | $141.25 | $281.84 |
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 $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
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 $44.67 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $44.67 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $79.43 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $63.10 | $79.43 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $44.67 | $56.23 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $22.91 | $28.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $85.11 | $107.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $14.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $79.43 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $63.10 | $79.43 | $100.00 |
Where Maine sits
The same service costs 3.4 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· 26th of 51
$174
AK $447KY $132
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.