How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $490 · 10th to 90th $363 to $724
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 $380.19 Median $457.09 Typical High $489.78 | Professional | None | $380.19 | $457.09 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $724.44 | Professional | None | $371.54 | $467.74 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | 50 · Both sides | $549.54 | $724.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $1,412.54 | Facility | None | $154.88 | $354.81 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $812.83 | Professional | None | $398.11 | $537.03 | $812.83 |
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 $354.81 Median $512.86 Typical High $851.14 | Professional | None | $354.81 | $512.86 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $489.78 | Professional | None | $389.05 | $457.09 | $489.78 |
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 $338.84 Median $467.74 Typical High $645.65 | Professional | None | $338.84 | $467.74 | $645.65 |
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 $194.98 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $346.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $229.09 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $91.20 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $338.84 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $48.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $346.74 |
Where Maine sits
The same service costs 5.2 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· 22nd of 51
$490
AK $1,514TX $288
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.