How much rates vary
Facilitymedian $1,905 · 10th to 90th $813 to $6,026Professionalmedian $490 · 10th to 90th $389 to $759
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 $407.38 Median $489.78 Typical High $489.78 | Professional | None | $407.38 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $758.58 Typical High $1,148.15 | Professional | 50 · Both sides | $588.84 | $758.58 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,606.93 | Facility | None | $812.83 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $776.25 | Professional | None | $426.58 | $537.03 | $776.25 |
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 $371.54 Median $489.78 Typical High $741.31 | Professional | None | $371.54 | $489.78 | $741.31 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | None | $457.09 | $489.78 | $489.78 |
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 $346.74 Median $489.78 Typical High $660.69 | Professional | None | $346.74 | $489.78 | $660.69 |
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 $204.17 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $338.84 | $363.08 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $48.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $338.84 |
Where Maine sits
The same service costs 7.2 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· 30th of 51
$490
AK $1,622TX $224
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.