How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $3,311Professionalmedian $437 · 10th to 90th $302 to $661
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 $331.13 Median $354.81 Typical High $549.54 | Professional | None | $331.13 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | None | $275.42 | $380.19 | $537.03 |
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 $389.05 Median $549.54 Typical High $645.65 | Professional | None | $389.05 | $549.54 | $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 $323.59 Median $501.19 Typical High $794.33 | Professional | None | $323.59 | $501.19 | $794.33 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $549.54 | Professional | None | $338.84 | $354.81 | $549.54 |
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 $436.52 Typical High $741.31 | Professional | None | $288.40 | $436.52 | $741.31 |
14 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 $177.83 Median $177.83 Typical High $275.42 | Professional | 52 · Reduced service | $177.83 | $177.83 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $109.65 | Professional | 53 · Discontinued | $70.79 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $269.15 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $575.44 Typical High $812.83 | Professional | 50 · Both sides | $416.87 | $575.44 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $239.88 Typical High $338.84 | Professional | 62 · Two surgeons | $173.78 | $239.88 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $275.42 | Professional | 52 · Reduced service | $177.83 | $177.83 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $109.65 | Professional | 53 · Discontinued | $70.79 | $70.79 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $269.15 | $407.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $54.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $380.19 |
Where Maine sits
The same service costs 5.9 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· 33rd of 51
$437
AK $1,413UT $240
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.