How much rates vary
Facilitymedian $1,000 · 10th to 90th $589 to $1,413Professionalmedian $617 · 10th to 90th $479 to $977
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 $588.84 Median $616.60 Typical High $616.60 | Facility | None | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $776.25 | Professional | None | $588.84 | $616.60 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $977.24 | Professional | None | $489.78 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | 50 · Both sides | $741.31 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $1,584.89 | Facility | None | $537.03 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,000.00 | Professional | None | $537.03 | $691.83 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $933.25 | Professional | None | $467.74 | $602.56 | $933.25 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $616.60 | Facility | None | $588.84 | $588.84 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | None | $616.60 | $616.60 | $776.25 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $812.83 | Professional | None | $436.52 | $588.84 | $812.83 |
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 $257.04 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $309.03 | $309.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $436.52 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $426.58 |
Where Maine sits
The same service costs 7.6 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· 30th of 51
$617
AK $2,042TX $269
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.