How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $339 · 10th to 90th $257 to $513
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 $263.03 Median $323.59 Typical High $338.84 | Professional | None | $263.03 | $323.59 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $512.86 | Professional | None | $263.03 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $524.81 Typical High $776.25 | Professional | 50 · Both sides | $398.11 | $524.81 | $776.25 |
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 $295.12 Median $389.05 Typical High $562.34 | Professional | None | $295.12 | $389.05 | $562.34 |
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 $257.04 Median $371.54 Typical High $588.84 | Professional | None | $257.04 | $371.54 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $338.84 | Professional | None | $263.03 | $323.59 | $338.84 |
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 $229.09 Median $331.13 Typical High $457.09 | Professional | None | $229.09 | $331.13 | $457.09 |
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 $141.25 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $213.80 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $199.53 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $162.18 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $66.07 | $67.61 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $245.47 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $32.36 | $33.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $239.88 |
Where Maine sits
The same service costs 5.9 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· 27th of 51
$339
AK $1,096TX $186
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.