How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $3,631Professionalmedian $1,995 · 10th to 90th $1,445 to $2,754
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 $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,698.24 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,290.87 | Facility | None | $707.95 | $1,122.02 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,344.23 | $3,162.28 |
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 $1,445.44 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,137.96 | $3,311.31 |
Martin's Point Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
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 $1,445.44 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,445.44 | $2,137.96 | $3,162.28 |
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 $891.25 Median $891.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $223.87 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,548.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,096.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $354.81 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $331.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $223.87 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $223.87 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,548.82 |
Where Maine sits
The same service costs 5.1 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· 28th of 51
$1,995
AK $5,248TX $1,023
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.