How much rates vary
Facilitymedian $501 · 10th to 90th $112 to $708Professionalmedian $138 · 10th to 90th $100 to $200
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 $112.20 Median $151.36 Typical High $199.53 | Professional | None | $112.20 | $151.36 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $190.55 | Professional | None | $100.00 | $131.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $162.18 Typical High $707.95 | Facility | None | $56.23 | $162.18 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $213.80 | Professional | None | $120.23 | $162.18 | $213.80 |
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 $97.72 Median $147.91 Typical High $257.04 | Professional | None | $97.72 | $147.91 | $257.04 |
Martin's Point Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $199.53 | Professional | None | $112.20 | $151.36 | $199.53 |
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 $89.13 Median $125.89 Typical High $194.98 | Professional | None | $89.13 | $125.89 | $194.98 |
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 $57.54 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 54 · Surgery only | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $57.54 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $22.91 | $30.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 54 · Surgery only | $85.11 | $85.11 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $104.71 |
Where Maine sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $2,944MD $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.