How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $5,754Professionalmedian $631 · 10th to 90th $407 to $1,230
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 $478.63 Median $501.19 Typical High $851.14 | Professional | None | $478.63 | $501.19 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $691.83 | Professional | None | $354.81 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,388.44 Typical High $5,495.41 | Facility | None | $707.95 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,047.13 | Professional | None | $501.19 | $776.25 | $1,047.13 |
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 $407.38 Median $691.83 Typical High $1,258.93 | Professional | None | $407.38 | $691.83 | $1,258.93 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $851.14 | Professional | None | $478.63 | $501.19 | $851.14 |
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 $380.19 Median $691.83 Typical High $1,412.54 | Professional | None | $380.19 | $691.83 | $1,412.54 |
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 $234.42 Median $251.19 Typical High $426.58 | Professional | 52 · Reduced service | $234.42 | $251.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $169.82 | Professional | 53 · Discontinued | $95.50 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $630.96 | Professional | 54 · Surgery only | $354.81 | $380.19 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $128.82 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $85.11 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $588.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $251.19 Typical High $426.58 | Professional | 52 · Reduced service | $234.42 | $251.19 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $169.82 | Professional | 53 · Discontinued | $95.50 | $100.00 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $630.96 | Professional | 54 · Surgery only | $354.81 | $371.54 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $128.82 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $85.11 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $85.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $588.84 |
Where Maine sits
The same service costs 4.9 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· 31st of 51
$631
AK $1,862TX $380
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.