How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $1,585Professionalmedian $269 · 10th to 90th $162 to $562
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 $186.21 Median $316.23 Typical High $602.56 | Professional | None | $186.21 | $316.23 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $316.23 | Professional | None | $141.25 | $208.93 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,412.54 | Facility | None | $537.03 | $1,000.00 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $602.56 | Professional | None | $199.53 | $363.08 | $602.56 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $707.95 | Professional | None | $165.96 | $323.59 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $602.56 | Professional | None | $186.21 | $316.23 | $602.56 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $602.56 | Professional | None | $147.91 | $316.23 | $602.56 |
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 $91.20 Median $91.20 Typical High $234.42 | Professional | 52 · Reduced service | $91.20 | $91.20 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $93.33 | Professional | 53 · Discontinued | $37.15 | $37.15 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $354.81 | Professional | 54 · Surgery only | $138.04 | $138.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $70.79 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $46.77 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $331.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $234.42 | Professional | 52 · Reduced service | $91.20 | $91.20 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $93.33 | Professional | 53 · Discontinued | $37.15 | $37.15 | $93.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $354.81 | Professional | 54 · Surgery only | $138.04 | $138.04 | $354.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $70.79 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $70.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $46.77 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $46.77 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $331.13 |
Where Maine sits
The same service costs 4.0 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· 44th of 51
$275
AK $759KY $191
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.