How much rates vary
Facilitymedian $501 · 10th to 90th $214 to $708Professionalmedian $389 · 10th to 90th $257 to $676
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 $218.78 Median $281.84 Typical High $309.03 | Professional | None | $218.78 | $281.84 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $676.08 | Professional | None | $263.03 | $389.05 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $309.03 Typical High $707.95 | Facility | None | $56.23 | $309.03 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $776.25 | Professional | None | $295.12 | $398.11 | $776.25 |
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 $295.12 Median $457.09 Typical High $676.08 | Professional | None | $295.12 | $457.09 | $676.08 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $288.40 | Professional | None | $218.78 | $281.84 | $288.40 |
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 $346.74 Median $478.63 Typical High $645.65 | Professional | None | $346.74 | $478.63 | $645.65 |
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 $109.65 Median $138.04 Typical High $144.54 | Professional | 52 · Reduced service | $109.65 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $138.04 Typical High $144.54 | Professional | 52 · Reduced service | $109.65 | $138.04 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $54.95 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $208.93 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $28.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $199.53 |
Where Maine sits
The same service costs 4.0 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· 18th of 51
$398
AK $1,096TX $275
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.