How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,072 to $4,898Professionalmedian $646 · 10th to 90th $501 to $955
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 $562.34 Median $645.65 Typical High $645.65 | Professional | None | $562.34 | $645.65 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $933.25 | Professional | None | $489.78 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $398.11 Typical High $588.84 | Professional | 62 · Two surgeons | $309.03 | $398.11 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,047.13 | Professional | None | $549.54 | $691.83 | $1,047.13 |
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 $524.81 Median $645.65 Typical High $977.24 | Professional | None | $524.81 | $645.65 | $977.24 |
Martin's Point Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
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 $501.19 Median $741.31 Typical High $1,000.00 | Professional | None | $501.19 | $741.31 | $1,000.00 |
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 $281.84 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $457.09 |
Where Maine sits
The same service costs 18.2 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· 30th of 51
$676
AK $1,995TX $110
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.