How much rates vary
Facilitymedian $741 · 10th to 90th $457 to $2,692Professionalmedian $513 · 10th to 90th $407 to $813
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 $426.58 Median $512.86 Typical High $512.86 | Professional | None | $426.58 | $512.86 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | 50 · Both sides | $616.60 | $812.83 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $2,951.21 | Facility | None | $537.03 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
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 $389.05 Median $501.19 Typical High $776.25 | Professional | None | $389.05 | $501.19 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
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 $363.08 Median $489.78 Typical High $676.08 | Professional | None | $363.08 | $489.78 | $676.08 |
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 $213.80 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $354.81 |
Where Maine sits
The same service costs 8.1 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· 29th of 51
$513
AK $1,698TX $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.