How much rates vary
Facilitymedian $501 · 10th to 90th $100 to $708Professionalmedian $120 · 10th to 90th $87 to $191
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 Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $128.82 | Facility | None | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $181.97 | Professional | None | $95.50 | $125.89 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $154.88 | Professional | None | $74.13 | $100.00 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $162.18 Typical High $1,412.54 | Facility | None | $70.79 | $162.18 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $199.53 | Professional | None | $102.33 | $144.54 | $199.53 |
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 $87.10 Median $128.82 Typical High $204.17 | Professional | None | $87.10 | $128.82 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $181.97 | Professional | None | $100.00 | $128.82 | $181.97 |
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 $81.28 Median $125.89 Typical High $204.17 | Professional | None | $81.28 | $125.89 | $204.17 |
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 $50.12 Median $50.12 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $151.36 Typical High $229.09 | Professional | 50 · Both sides | $114.82 | $151.36 | $229.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $50.12 | $64.57 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $19.95 | $25.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $75.86 | $97.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $19.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $12.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $91.20 |
Where Maine sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 29th of 51
$123
AK $324FL $83.18
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.