How much rates vary
Facilitymedian $832 · 10th to 90th $708 to $1,950Professionalmedian $537 · 10th to 90th $380 to $776
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 $407.38 Median $467.74 Typical High $676.08 | Professional | None | $407.38 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $707.95 | Professional | None | $346.74 | $489.78 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $724.44 Typical High $1,047.13 | Professional | 50 · Both sides | $537.03 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,000.00 Typical High $2,818.38 | Facility | None | $851.14 | $1,000.00 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $831.76 | Professional | None | $501.19 | $691.83 | $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 $426.58 Median $630.96 Typical High $977.24 | Professional | None | $426.58 | $630.96 | $977.24 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $676.08 | Professional | None | $436.52 | $467.74 | $676.08 |
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 $371.54 Median $549.54 Typical High $891.25 | Professional | None | $371.54 | $549.54 | $891.25 |
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 $234.42 Median $234.42 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $478.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $234.42 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $93.33 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $354.81 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $67.61 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $478.63 |
Where Maine sits
The same service costs 4.8 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· 31st of 51
$537
AK $1,549UT $324
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.