How much rates vary
Facilitymedian $1,698 · 10th to 90th $355 to $2,570Professionalmedian $398 · 10th to 90th $295 to $603
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 $354.81 Median $354.81 Typical High $501.19 | Professional | None | $354.81 | $354.81 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $501.19 | Professional | None | $257.04 | $354.81 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $676.08 Typical High $2,290.87 | Facility | None | $302.00 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $645.65 | Professional | None | $363.08 | $501.19 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $724.44 | Professional | None | $302.00 | $467.74 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | None | $354.81 | $354.81 | $501.19 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $676.08 | Professional | None | $281.84 | $407.38 | $676.08 |
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 $173.78 Median $173.78 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $70.79 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $346.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $173.78 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $70.79 | $70.79 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $263.03 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $50.12 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $346.74 |
Where Maine sits
The same service costs 5.2 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· 29th of 51
$398
AK $1,148TX $219
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.