How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,698Professionalmedian $851 · 10th to 90th $589 to $1,148
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 $724.44 Median $741.31 Typical High $870.96 | Professional | None | $724.44 | $741.31 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,122.02 | Professional | None | $575.44 | $741.31 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $1,862.09 | Facility | None | $707.95 | $891.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,348.96 | Professional | None | $707.95 | $954.99 | $1,348.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,348.96 | Professional | None | $588.84 | $891.25 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | None | $741.31 | $741.31 | $870.96 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,230.27 | Professional | None | $549.54 | $812.83 | $1,230.27 |
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 $363.08 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $371.54 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $147.91 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $87.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Where Maine sits
The same service costs 5.6 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· 22nd of 51
$851
AK $2,399TX $427
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.