How much rates vary
Facilitymedian $234 · 10th to 90th $141 to $692Professionalmedian $219 · 10th to 90th $135 to $347
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 Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Facility | None | $141.25 | $141.25 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $346.74 | Professional | None | $141.25 | $229.09 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $234.42 | Professional | None | $114.82 | $173.78 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $398.11 | Professional | None | $165.96 | $275.42 | $398.11 |
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 $144.54 Median $234.42 Typical High $407.38 | Professional | None | $144.54 | $234.42 | $407.38 |
Martin's Point Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $251.19 | Facility | None | $134.90 | $141.25 | $251.19 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $346.74 | Professional | None | $141.25 | $229.09 | $346.74 |
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 $138.04 Median $229.09 Typical High $331.13 | Professional | None | $138.04 | $229.09 | $331.13 |
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 $70.79 Median $72.44 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $177.83 | Professional | 54 · Surgery only | $104.71 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $72.44 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $72.44 | $117.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $29.51 | $46.77 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $177.83 | Professional | 54 · Surgery only | $104.71 | $109.65 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $35.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $23.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $165.96 |
Where Maine sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 25th of 51
$219
AK $501KY $112
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.