How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,000 to $5,754Professionalmedian $759 · 10th to 90th $525 to $1,096
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 $588.84 Median $588.84 Typical High $776.25 | Professional | None | $588.84 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $870.96 | Professional | None | $426.58 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,174.90 | Professional | None | $602.56 | $812.83 | $1,174.90 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,202.26 | Professional | None | $524.81 | $812.83 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $776.25 | Professional | None | $588.84 | $588.84 | $776.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,122.02 | Professional | None | $630.96 | $870.96 | $1,122.02 |
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 $295.12 Median $295.12 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $537.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $117.49 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $446.68 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $537.03 |
Where Maine sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$776
AK $2,344UT $468
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.