How much rates vary
Facilitymedian $2,291 · 10th to 90th $813 to $6,026Professionalmedian $759 · 10th to 90th $603 to $1,175
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 $758.58 Median $758.58 Typical High $1,122.02 | Professional | None | $758.58 | $758.58 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,174.90 | Professional | None | $602.56 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,606.93 | Facility | None | $812.83 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,230.27 | Professional | None | $691.83 | $851.14 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,122.02 | Professional | None | $588.84 | $741.31 | $1,122.02 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,122.02 | Professional | None | $758.58 | $758.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,023.29 | Professional | None | $575.44 | $741.31 | $1,023.29 |
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 $309.03 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $537.03 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $537.03 |
Where Maine sits
The same service costs 8.1 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· 33rd of 51
$776
AK $2,512TX $309
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.