How much rates vary
Facilitymedian $457 · 10th to 90th $324 to $832Professionalmedian $398 · 10th to 90th $275 to $589
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 Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $457.09 | Facility | None | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $660.69 | Professional | None | $302.00 | $457.09 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $501.19 | Professional | None | $251.19 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $457.09 Typical High $707.95 | Facility | None | $56.23 | $457.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $602.56 | Professional | None | $363.08 | $501.19 | $602.56 |
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 $288.40 Median $426.58 Typical High $758.58 | Professional | None | $288.40 | $426.58 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $707.95 | Professional | None | $316.23 | $457.09 | $707.95 |
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 $263.03 Median $371.54 Typical High $575.44 | Professional | None | $263.03 | $371.54 | $575.44 |
14 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 $162.18 Median $162.18 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $53.70 Typical High $81.28 | Professional | 80 · Assistant surgeon | $41.69 | $53.70 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $46.77 Typical High $70.79 | Professional | AS · PA/NP assist | $36.31 | $46.77 | $70.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $162.18 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $64.57 | $91.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $245.47 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $45.71 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $323.59 |
Where Maine sits
The same service costs 4.5 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· 27th of 51
$398
AK $1,072TX $240
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.