How much rates vary
Facilitymedian $525 · 10th to 90th $174 to $708Professionalmedian $724 · 10th to 90th $537 to $1,096
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 $575.44 Median $645.65 Typical High $891.25 | Professional | None | $575.44 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $912.01 | Professional | None | $457.09 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $338.84 Typical High $2,290.87 | Facility | None | $147.91 | $338.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,202.26 | Professional | None | $660.69 | $933.25 | $1,202.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,348.96 | Professional | None | $537.03 | $831.76 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $891.25 | Professional | None | $588.84 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,202.26 | Professional | None | $524.81 | $794.33 | $1,202.26 |
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 $323.59 Median $323.59 Typical High $446.68 | Professional | 52 · Reduced service | $323.59 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | 54 · Surgery only | $489.78 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $630.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $446.68 | Professional | 52 · Reduced service | $323.59 | $323.59 | $446.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | 54 · Surgery only | $489.78 | $489.78 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $89.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $630.96 |
Where Maine sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 32nd of 51
$724
AK $1,950MD $537
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.