How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,585Professionalmedian $479 · 10th to 90th $339 to $724
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 Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Facility | None | $398.11 | $398.11 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $602.56 | Professional | None | $380.19 | $549.54 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $602.56 | Professional | None | $295.12 | $416.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,862.09 | Facility | None | $707.95 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $707.95 | Professional | None | $426.58 | $602.56 | $707.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $870.96 | Professional | None | $354.81 | $537.03 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $758.58 | Professional | None | $398.11 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $794.33 | Professional | None | $316.23 | $478.63 | $794.33 |
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 $199.53 Median $199.53 Typical High $302.00 | Professional | 52 · Reduced service | $199.53 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $446.68 | Professional | 54 · Surgery only | $302.00 | $302.00 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $616.60 Typical High $891.25 | Professional | 50 · Both sides | $457.09 | $616.60 | $891.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $302.00 | Professional | 52 · Reduced service | $199.53 | $199.53 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $79.43 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $446.68 | Professional | 54 · Surgery only | $302.00 | $302.00 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $60.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $416.87 |
Where Maine sits
The same service costs 4.9 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· 29th of 51
$479
AK $1,413UT $288
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.