How much rates vary
Facilitymedian $741 · 10th to 90th $457 to $1,413Professionalmedian $263 · 10th to 90th $182 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 $223.87 Median $223.87 Typical High $354.81 | Professional | None | $223.87 | $223.87 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $338.84 | Professional | None | $169.82 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $354.81 Typical High $501.19 | Professional | 50 · Both sides | $257.04 | $354.81 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,412.54 | Facility | None | $537.03 | $1,000.00 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $416.87 | Professional | None | $229.09 | $338.84 | $416.87 |
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 $194.98 Median $302.00 Typical High $524.81 | Professional | None | $194.98 | $302.00 | $524.81 |
Martin's Point Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $354.81 | Professional | None | $223.87 | $223.87 | $354.81 |
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 $177.83 Median $275.42 Typical High $446.68 | Professional | None | $177.83 | $275.42 | $446.68 |
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 $112.20 Median $112.20 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $169.82 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $245.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $112.20 | $177.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $44.67 | $70.79 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $169.82 | $169.82 | $263.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $52.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $35.48 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $245.47 |
Where Maine sits
The same service costs 4.1 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· 35th of 51
$269
AK $851TX $209
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.