How much rates vary
Facilitymedian $1,905 · 10th to 90th $813 to $7,586Professionalmedian $295 · 10th to 90th $195 to $479
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 $234.42 Median $234.42 Typical High $436.52 | Professional | None | $234.42 | $234.42 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $363.08 | Professional | None | $181.97 | $257.04 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,248.07 Typical High $8,511.38 | Facility | None | $812.83 | $5,248.07 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $512.86 | Professional | None | $251.19 | $371.54 | $512.86 |
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 $213.80 Median $338.84 Typical High $616.60 | Professional | None | $213.80 | $338.84 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $436.52 | Professional | None | $234.42 | $234.42 | $436.52 |
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 $186.21 Median $323.59 Typical High $575.44 | Professional | None | $186.21 | $323.59 | $575.44 |
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 $117.49 Median $117.49 Typical High $218.78 | Professional | 52 · Reduced service | $117.49 | $117.49 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $46.77 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $323.59 | Professional | 54 · Surgery only | $173.78 | $173.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $389.05 Typical High $524.81 | Professional | 50 · Both sides | $269.15 | $389.05 | $524.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $112.20 Median $162.18 Typical High $218.78 | Professional | 62 · Two surgeons | $112.20 | $162.18 | $218.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $218.78 | Professional | 52 · Reduced service | $117.49 | $117.49 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $46.77 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $323.59 | Professional | 54 · Surgery only | $173.78 | $173.78 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $43.65 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $302.00 |
Where Maine sits
The same service costs 5.1 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· 40th of 51
$295
AK $977TX $191
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.