How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $3,631Professionalmedian $2,630 · 10th to 90th $1,905 to $3,631
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 $2,238.72 Median $2,344.23 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,344.23 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,238.72 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,467.37 Typical High $4,897.79 | Professional | 50 · Both sides | $2,570.40 | $3,467.37 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,318.26 Typical High $2,290.87 | Facility | None | $707.95 | $1,318.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,187.76 | $2,951.21 | $4,073.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,691.53 | $4,265.80 |
Martin's Point Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,818.38 | Professional | None | $2,344.23 | $2,344.23 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,754.23 | $4,168.69 |
10 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 $1,122.02 Median $1,174.90 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,122.02 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $478.63 Typical High $575.44 | Professional | 53 · Discontinued | $446.68 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $354.81 Typical High $426.58 | Professional | 55 · Aftercare only | $338.84 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $234.42 Typical High $281.84 | Professional | 56 · Pre-op care only | $223.87 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,659.59 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,659.59 | $1,995.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,412.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 53 · Discontinued | $478.63 | $478.63 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $426.58 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $281.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,995.26 |
Where Maine sits
The same service costs 5.5 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· 30th of 51
$2,570
AK $6,918TX $1,259
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.