How much rates vary
Facilitymedian $501 · 10th to 90th $110 to $708Professionalmedian $151 · 10th to 90th $91 to $275
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 $77.62 Median $114.82 Typical High $147.91 | Professional | None | $77.62 | $114.82 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $281.84 | Professional | None | $97.72 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $162.18 Typical High $707.95 | Facility | None | $56.23 | $162.18 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $288.40 | Professional | None | $104.71 | $169.82 | $288.40 |
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 $104.71 Median $181.97 Typical High $281.84 | Professional | None | $104.71 | $181.97 | $281.84 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $154.88 | Professional | None | $77.62 | $120.23 | $154.88 |
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 $123.03 Median $181.97 Typical High $269.15 | Professional | None | $123.03 | $181.97 | $269.15 |
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 $38.90 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $69.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $53.70 | $69.18 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $50.12 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $19.95 | $23.99 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $74.13 | $89.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $12.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $69.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $53.70 | $69.18 | $83.18 |
Where Maine sits
The same service costs 3.5 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· 20th of 51
$155
AK $389KY $110
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.