How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $407 · 10th to 90th $302 to $603
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 $295.12 Median $380.19 Typical High $407.38 | Professional | None | $295.12 | $380.19 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $602.56 | Professional | None | $309.03 | $398.11 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $1,412.54 | Facility | None | $154.88 | $354.81 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $676.08 | Professional | None | $354.81 | $457.09 | $676.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $707.95 | Professional | None | $302.00 | $436.52 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $407.38 | Professional | None | $309.03 | $380.19 | $407.38 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $537.03 | Professional | None | $275.42 | $389.05 | $537.03 |
13 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 $165.96 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $81.28 | Professional | 53 · Discontinued | $66.07 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $602.56 Typical High $891.25 | Professional | 50 · Both sides | $457.09 | $602.56 | $891.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $190.55 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $75.86 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $269.15 | $281.84 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $40.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $288.40 |
Where Maine sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 23rd of 51
$407
AK $1,259UT $219
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.