How much rates vary
Facilitymedian $708 · 10th to 90th $214 to $1,202Professionalmedian $245 · 10th to 90th $166 to $363
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 $165.96 Median $239.88 Typical High $281.84 | Professional | None | $165.96 | $239.88 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $416.87 Typical High $1,412.54 | Facility | None | $181.97 | $416.87 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $338.84 | Professional | None | $194.98 | $288.40 | $338.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $436.52 | Professional | None | $162.18 | $245.47 | $436.52 |
Martin's Point Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $281.84 | Professional | None | $173.78 | $257.04 | $281.84 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $338.84 | Professional | None | $147.91 | $213.80 | $338.84 |
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 $93.33 Median $93.33 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $93.33 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $37.15 | $53.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $141.25 | $199.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $39.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $26.92 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $186.21 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$245
AK $603FL $174
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.