How much rates vary
Facilitymedian $708 · 10th to 90th $251 to $1,202Professionalmedian $257 · 10th to 90th $170 to $398
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 $204.17 Median $288.40 Typical High $331.13 | Professional | None | $204.17 | $288.40 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $302.00 | Professional | None | $154.88 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $457.09 Typical High $1,412.54 | Facility | None | $213.80 | $457.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $389.05 | Professional | None | $208.93 | $309.03 | $389.05 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $501.19 | Professional | None | $181.97 | $275.42 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $331.13 | Professional | None | $204.17 | $288.40 | $331.13 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $416.87 | Professional | None | $158.49 | $251.19 | $416.87 |
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 $102.33 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $102.33 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $66.07 | Professional | 53 · Discontinued | $40.74 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $151.36 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | 50 · Both sides | $229.09 | $316.23 | $457.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $102.33 | $102.33 | $165.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $66.07 | Professional | 53 · Discontinued | $40.74 | $40.74 | $66.07 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $151.36 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $33.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $229.09 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 30th of 51
$257
AK $646KY $182
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.