How much rates vary
Facilitymedian $501 · 10th to 90th $151 to $708Professionalmedian $275 · 10th to 90th $209 to $417
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 $213.80 Median $275.42 Typical High $416.87 | Professional | None | $213.80 | $275.42 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | None | $208.93 | $269.15 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $218.78 Typical High $707.95 | Facility | None | $56.23 | $218.78 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $446.68 | Professional | None | $239.88 | $309.03 | $446.68 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | None | $208.93 | $295.12 | $446.68 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $416.87 | Professional | None | $229.09 | $275.42 | $416.87 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $363.08 | Professional | None | $190.55 | $269.15 | $363.08 |
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 $112.20 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $112.20 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $56.23 | Professional | 53 · Discontinued | $44.67 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $41.69 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $154.88 | $181.97 | $194.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $128.82 | $138.04 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $52.48 | $56.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $194.98 | $208.93 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $27.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $181.97 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $169.82 | $181.97 | $194.98 |
Where Maine sits
The same service costs 5.1 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· 21st of 51
$275
AK $871UT $170
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.