How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $479 · 10th to 90th $355 to $708
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 $371.54 Median $478.63 Typical High $707.95 | Professional | None | $371.54 | $478.63 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $691.83 | Professional | None | $354.81 | $457.09 | $691.83 |
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 $416.87 Median $537.03 Typical High $794.33 | Professional | None | $416.87 | $537.03 | $794.33 |
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 $831.76 | Professional | None | $354.81 | $512.86 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $707.95 | Professional | None | $380.19 | $478.63 | $707.95 |
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 $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
13 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 $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $194.98 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $77.62 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $269.15 | $309.03 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $691.83 Typical High $1,047.13 | Professional | 50 · Both sides | $537.03 | $691.83 | $1,047.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $218.78 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $87.10 | $95.50 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $331.13 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $47.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $338.84 |
Where Maine sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$479
AK $1,479UT $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.