How much rates vary
Facilitymedian $1,738 · 10th to 90th $813 to $2,570Professionalmedian $398 · 10th to 90th $288 to $550
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 $338.84 Median $407.38 Typical High $524.81 | Professional | None | $338.84 | $407.38 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $537.03 | Professional | None | $269.15 | $331.13 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,290.87 | Facility | None | $812.83 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $645.65 | Professional | None | $338.84 | $436.52 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $602.56 | Professional | None | $288.40 | $398.11 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $524.81 | Professional | None | $363.08 | $407.38 | $524.81 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $549.54 | Professional | None | $275.42 | $389.05 | $549.54 |
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 $162.18 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $177.83 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $251.19 | $269.15 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $40.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $281.84 |
Where Maine sits
The same service costs 6.8 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· 28th of 51
$398
AK $1,288UT $191
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.