How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $2,291Professionalmedian $933 · 10th to 90th $724 to $1,380
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 $933.25 Typical High $933.25 | Professional | None | $758.58 | $933.25 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,380.38 | Professional | None | $724.44 | $933.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,412.54 Typical High $2,089.30 | Professional | 50 · Both sides | $1,071.52 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,290.87 | Facility | None | $707.95 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,479.11 | Professional | None | $812.83 | $1,023.29 | $1,479.11 |
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 $724.44 Median $933.25 Typical High $1,348.96 | Professional | None | $724.44 | $933.25 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | None | $870.96 | $933.25 | $933.25 |
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 $707.95 Median $933.25 Typical High $1,258.93 | Professional | None | $707.95 | $933.25 | $1,258.93 |
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 $380.19 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $660.69 |
Where Maine sits
The same service costs 4.3 times more in Alaska than in Alabama. 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.
Physician feeFacility fee
AK $6,582AL $1,537
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.