How much rates vary
Facilitymedian $501 · 10th to 90th $182 to $708Professionalmedian $427 · 10th to 90th $309 to $617
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 $302.00 Median $389.05 Typical High $426.58 | Professional | None | $302.00 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | None | $316.23 | $407.38 | $616.60 |
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 $363.08 Median $478.63 Typical High $691.83 | Professional | None | $363.08 | $478.63 | $691.83 |
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 $309.03 Median $457.09 Typical High $724.44 | Professional | None | $309.03 | $457.09 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $426.58 | Professional | None | $302.00 | $389.05 | $426.58 |
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 $288.40 Median $407.38 Typical High $549.54 | Professional | None | $288.40 | $407.38 | $549.54 |
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 $169.82 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $275.42 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | 50 · Both sides | $467.74 | $616.60 | $912.01 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $194.98 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $77.62 | $85.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $275.42 | $295.12 | $316.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $63.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $42.66 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $295.12 |
Where Maine sits
The same service costs 5.9 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· 21st of 51
$427
AK $1,288UT $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.