How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $3,890Professionalmedian $1,047 · 10th to 90th $832 to $1,660
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | None | $851.14 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,659.59 | Professional | None | $831.76 | $1,071.52 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,778.28 | Professional | None | $912.01 | $1,230.27 | $1,778.28 |
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 $794.33 Median $1,023.29 Typical High $1,621.81 | Professional | None | $794.33 | $1,023.29 | $1,621.81 |
Martin's Point Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,047.13 | $1,047.13 |
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 $724.44 Median $977.24 Typical High $1,348.96 | Professional | None | $724.44 | $977.24 | $1,348.96 |
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 $426.58 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $741.31 |
Where Maine sits
The same service costs 7.2 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· 26th of 51
$1,047
AK $3,467TX $479
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.