How much rates vary
Facilitymedian $501 · 10th to 90th $151 to $708Professionalmedian $214 · 10th to 90th $155 to $302
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 $169.82 Median $190.55 Typical High $229.09 | Professional | None | $169.82 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $295.12 | Professional | None | $151.36 | $199.53 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $295.12 Typical High $436.52 | Professional | 50 · Both sides | $229.09 | $295.12 | $436.52 |
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 $181.97 Median $239.88 Typical High $354.81 | Professional | None | $181.97 | $239.88 | $354.81 |
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 $151.36 Median $229.09 Typical High $371.54 | Professional | None | $151.36 | $229.09 | $371.54 |
Martin's Point Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | None | $173.78 | $190.55 | $229.09 |
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 $144.54 Median $204.17 Typical High $302.00 | Professional | None | $144.54 | $204.17 | $302.00 |
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 $89.13 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $134.90 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $125.89 | $131.83 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $95.50 | $114.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $38.02 | $45.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $141.25 | $141.25 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.91 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $158.49 |
Where Maine sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 22nd of 51
$219
AK $617FL $135
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.