How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,020Professionalmedian $550 · 10th to 90th $363 to $851
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 $436.52 Median $436.52 Typical High $741.31 | Professional | None | $436.52 | $436.52 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $741.31 | Professional | None | $354.81 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $724.44 Typical High $1,047.13 | Professional | 50 · Both sides | $537.03 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,089.30 | Facility | None | $707.95 | $1,584.89 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $870.96 | Professional | None | $467.74 | $707.95 | $870.96 |
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 $380.19 Median $660.69 Typical High $1,202.26 | Professional | None | $380.19 | $660.69 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $741.31 | Professional | None | $436.52 | $436.52 | $741.31 |
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 $331.13 Median $549.54 Typical High $933.25 | Professional | None | $331.13 | $549.54 | $933.25 |
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 $218.78 Median $218.78 Typical High $371.54 | Professional | 52 · Reduced service | $218.78 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | 53 · Discontinued | $87.10 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $562.34 | Professional | 54 · Surgery only | $323.59 | $323.59 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $112.20 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $74.13 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $524.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $371.54 | Professional | 52 · Reduced service | $218.78 | $218.78 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | 53 · Discontinued | $87.10 | $87.10 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $562.34 | Professional | 54 · Surgery only | $323.59 | $323.59 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $112.20 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $74.13 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $74.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $524.81 |
Where Maine sits
The same service costs 4.7 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
$550
AK $1,660TX $355
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.