How much rates vary
Facilitymedian $501 · 10th to 90th $145 to $708Professionalmedian $214 · 10th to 90th $132 to $398
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 $112.20 Median $165.96 Typical High $245.47 | Professional | None | $112.20 | $165.96 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $398.11 | Professional | None | $138.04 | $218.78 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $208.93 Typical High $707.95 | Facility | None | $56.23 | $208.93 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $407.38 | Professional | None | $151.36 | $239.88 | $407.38 |
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 $154.88 Median $251.19 Typical High $398.11 | Professional | None | $154.88 | $251.19 | $398.11 |
Martin's Point Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $251.19 | Professional | None | $112.20 | $165.96 | $251.19 |
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 $177.83 Median $257.04 Typical High $371.54 | Professional | None | $177.83 | $257.04 | $371.54 |
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 $56.23 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $70.79 | $83.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $28.18 | $33.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $104.71 | $125.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $25.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $16.60 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $117.49 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$219
AK $550MD $158
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.