How much rates vary
Facilitymedian $1,698 · 10th to 90th $372 to $2,570Professionalmedian $427 · 10th to 90th $288 to $646
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 $316.23 Median $363.08 Typical High $562.34 | Professional | None | $316.23 | $363.08 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $575.44 Typical High $831.76 | Professional | 50 · Both sides | $426.58 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $691.83 Typical High $2,290.87 | Facility | None | $316.23 | $691.83 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $660.69 | Professional | None | $398.11 | $562.34 | $660.69 |
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 $323.59 Median $501.19 Typical High $812.83 | Professional | None | $323.59 | $501.19 | $812.83 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $562.34 | Professional | None | $316.23 | $363.08 | $562.34 |
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 $288.40 Median $446.68 Typical High $741.31 | Professional | None | $288.40 | $446.68 | $741.31 |
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 $181.97 Median $181.97 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $389.05 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $181.97 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $181.97 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $72.44 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $269.15 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $389.05 |
Where Maine sits
The same service costs 4.7 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
$437
AK $1,175UT $251
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.