How much rates vary
Facilitymedian $2,692 · 10th to 90th $813 to $6,310Professionalmedian $676 · 10th to 90th $525 to $1,047
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 $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,047.13 | Professional | None | $537.03 | $707.95 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | 50 · Both sides | $812.83 | $1,047.13 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $2,951.21 | Facility | None | $812.83 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,096.48 | Professional | None | $602.56 | $758.58 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,023.29 | Professional | None | $512.86 | $660.69 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | None | $645.65 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $891.25 | Professional | None | $501.19 | $660.69 | $891.25 |
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 $275.42 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
Where Maine sits
The same service costs 7.9 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
$676
AK $2,239TX $282
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.