How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $3,311Professionalmedian $708 · 10th to 90th $525 to $1,023
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 $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $933.25 | Professional | None | $457.09 | $630.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,096.48 | Professional | None | $645.65 | $870.96 | $1,096.48 |
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 $549.54 Median $794.33 Typical High $1,230.27 | Professional | None | $549.54 | $794.33 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
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 $501.19 Median $707.95 Typical High $1,148.15 | Professional | None | $501.19 | $707.95 | $1,148.15 |
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 $316.23 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $602.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $316.23 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $467.74 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $85.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $602.56 |
Where Maine sits
The same service costs 5.8 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· 33rd of 51
$708
AK $2,455TX $427
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.